Real-World Treatment Response to Adalimumab and Secukinumab in Chinese Adults with Hidradenitis Suppurativa: A Retrospective Cohort Study.

BACKGROUND: Biologic therapies have transformed the management of moderate-to-severe hidradenitis suppurativa (HS). However, real-world comparative data between tumor necrosis factor-alpha (TNF-α) inhibitors and interleukin-17 (IL-17) inhibitors in Chinese populations remain limited. OBJECTIVE: To compare the short- and mid-term effectiveness and safety of TNF-α versus IL-17 inhibitors in adult Chinese patients with HS. METHODS: This single-center retrospective cohort study included adult patients (≥18 years) with moderate-to-severe HS treated with biologics. Patients were stratified into TNF-α inhibitor and IL-17 inhibitor groups. The primary endpoint was achievement of Hidradenitis Suppurativa Clinical Response (HiSCR50) at week 16. Secondary endpoints included HiSCR50 at weeks 12, and safety outcomes. RESULTS: A total of 79 adult patients were included (TNF-α: n=25; IL-17: n=54). At week 12, response rates remained similar (72.0% vs. 63.0%). By week 16, a decline in response was observed in the TNF-α group (56.0%), whereas the IL-17 group maintained a stable response (66.7%). Safety profiles were acceptable in both groups, with one discontinuation due to fungal infection in the IL-17 group. CONCLUSION: Both TNF-α and IL-17 inhibitors demonstrate rapid onset of action in HS. However, IL-17 inhibitors may offer superior mid-term durability of response, supporting their role as a preferred option for sustained disease control.