New and Emerging Targeted Therapies for Hidradenitis Suppurativa
Open accessAbstract
Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory skin disease deriving from the hair follicles. The formation of inflammatory nodules, abscesses, fistulas, and sinus tracts is characterized by a large inflow of key pro-inflammatory mediators, such as IFN-γ, TNF-α, IL-1, IL-17, and IL-12/23. Adalimumab is currently the only Food and Drug Administration (FDA)- and European Medicines Agency (EMA)-approved biologic therapy for moderate to severe HS in adults and adolescents. However, the long-term effectiveness of this TNF-α inhibitor in HS patients has shown to be highly variable. This review aims to review the evidence for emerging therapies that target the main pro-inflammatory cytokines in HS pathogenesis. A review of the literature was conducted, using the PubMed and Google Scholar repositories, as well as Clinicaltrials.gov. Presently, the most promising biologics in phase III trials are anti-IL-17 antibodies, secukinumab, and bimekizumab. Furthermore, an anti-IL-1 biologic, bermekimab, is currently in phase II trials, and shows encouraging results. Overall, the clinical efficacies of all new targeted therapies published up to this point are limited. More studies need to be performed to clarify the precise molecular pathology, and assess the efficacy of biological therapies for HS.
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In advanced hidradenitis suppurativa with tunnel formation and fibrosis, surgical management remains essential, often combined with medical therapy to control inflammation and prevent recurrence.
“In advanced diseases with tunnel formation and fibrosis, surgical management remains essential, often combined with medical therapy to control inflammation and prevent recurrence [40,44,45,46,47].”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [44]
Section 3.3 recommends surgery for severe hidradenitis suppurativa with sinus tracts and describes extensive procedures for advanced disease. The Discussion says conservative therapy combined with surgery produced the best clinical outcomes. The paper does not say that combining medical therapy with surgery prevents recurrence; Section 3.3 notes that relapses remain possible after surgery. (LLM, conf=0.84)
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Evidence on Hidradenitis Suppurativa as an Autoinflammatory Skin Disease
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Role of interleukins in dermatology: Exploring the immune mechanisms in skin diseases
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Inflammasomes: emerging therapeutic targets in hidradenitis suppurativa?
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An updated safety review of Hidradenitis Suppurativa treatment options
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Hidradenitis Suppurativa in Children and Adolescents: An Update on Pharmacologic Treatment Options
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Biologic therapies and small molecules in the treatment of hidradenitis suppurativa
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Infliximab inhibits TNF-α-dependent activation of the NLRP3/IL-1β pathway in acne inversa
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The role of piperacillin/tazobactam in the treatment of Hidradenitis suppurativa
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12th EHSF Conference 2023 Extended Abstracts
chronic, S. H. A. A. P. B. I. A. I. A. O. Q. O. L. T. C. B. A. B. H. S. (. H. I. A., long-term, O., body, A.-I. S. D. T. A. I. A. O. T., armpits, L. T., areas., I. A. G., relationship., S. I. A. B. H. N. T. I. H. B. T. S. T. B. O. V. I. F. M. H. A. O. Q. O. L. T. S. O. H. C. A. O. A. T. I. S. A. H. I. R. I. S. E. S. I. P. W. H. F. T. 7. O. P. S. T. H. N. A. T., sexuality, W. W. K. F. C. E. T. M. P. H. Q. A. S. H. T. M. B. H. T. S. T. C. N. O. P. B. A. N. F. I. D. T. D. S. H. A. S. F. S. E. A. I. 2. S. T. A. 9. O. N. U. H. P. D. M. A. T., concerns, 8. D. N. T. T. T. D. S., concerns., A. D. N. F. C. I. T. A. T. A. P. S., & partner., A. A. N. I. O. R. T. H. B. T. G. A. M. T. P. F. C. A. C. E. T. D. T. S. H. T. C. B. D. B. I. T. C. A. T. T. T. D. T. S. H. N. S. H. N. C. R. F. P. I. O. W. T. M. I. D. F. T. T. O. H. T. D. H. W. A. N. (2023) · Experimental Dermatology · doi:10.1111/exd.14898 · Cited by 3 · see citing works
Long-Term Efficacy of Guselkumab in an Adolescent Hidradenitis Suppurativa Patients: A Case Report
Martora, F., Battista, T., Potestio, L., Portarapillo, A., Tommasino, N., & Megna, M. (2024) · Clinical Cosmetic and Investigational Dermatology · doi:10.2147/ccid.s456817 · Cited by 3 · see citing works
Unlocking the Mechanisms of Hidradenitis Suppurativa: Inflammation and miRNA Insights
Ames, E., Sanders, M., Jacobs, M., & Vida, T. A. (2024) · Clinical Cosmetic and Investigational Dermatology · doi:10.2147/ccid.s483871 · Cited by 3 · see citing works
Martora, F., Annunziata, M. C., Potestio, L., Battista, T., Ruggiero, A., & Megna, M. (2024) · Clinical Cosmetic and Investigational Dermatology · doi:10.2147/ccid.s468268 · Cited by 2 · see citing works
Boucher, A., Peters, M., & Jones, G. B. (2024) · Dermatology and Therapy · doi:10.1007/s13555-024-01234-9 · Cited by 1 · see citing works
A case of secukinumab-induced psoriasis in a 25-year-old man with improved hidradenitis suppurativa
Yousefian, F., Griffith, V., Stallings, A., & Rupley, K. (2024) · JAAD Case Reports · doi:10.1016/j.jdcr.2024.08.027 · Cited by 2 · see citing works
Lu, H.-Y., Su, Y., Chang, H.-C., & Gau, S. (2025) · Research Square · doi:10.21203/rs.3.rs-7357330/v1 · Cited by 1 · see citing works
Tinca, A. C., Cozac-Szoke, A. R., & Cotoi, O. S. (2026) · Dermatopathology · doi:10.3390/dermatopathology13020022 · Cited by 1 · see citing works
Olaoye, I., & Casado, A. (2024) · Journal of Dermatology for Physician Assistants · doi:10.1097/jdpa.0000000000000042 · Cited by 1 · see citing works
Soto‐Moreno, A., Haselgruber, S., Osorio-Gomez, G. F., Fernández‐Crehuet, P., Ortiz‐Álvarez, J., Segura-Palacios, J. M., Navarro-Guillamón, P. J., Gómez-Torrente, A. P., Ballesteros, M. D. F., Llamas‐Molina, J. M., et al. (2025) · Journal of Dermatological Treatment · doi:10.1080/09546634.2025.2512156 · Cited by 1 · see citing works
New Biologic and Small Molecule Therapies for Hidradenitis Suppurativa
Pender, E., Hughes, R., & Kirby, B. (2026) · JEADV Clinical Practice · doi:10.1002/jvc2.70268 · Cited by 1 · see citing works
Cerebral Tuberculosis After Therapy With Adalimumab for Hidradenitis Suppurativa: A Rare Case
Martins, F., Rodrigues, A. S. D. C., Oliveira, J. N., Malheiro, R., & Cerqueira, L. M. G. (2024) · Cureus · doi:10.7759/cureus.52267 · Cited by 1 · see citing works
Martora, F., Potestio, L., Battista, T., & Megna, M. (2024) · Journal of the European Academy of Dermatology and Venereology · doi:10.1111/jdv.19837 · Cited by 1 · see citing works
The complement system and its role in the treatment of ANCA-associated vasculitis
Rybak, N., Dudek, I., Czarnota, J., Dobrzyński, M., Skubel, T., & Drozd, M. (2022) · Journal of Education Health and Sport · doi:10.12775/jehs.2022.12.08.088
INTERLEUKIN -23, APPLICATION PROSPECTS (LITERATURE REVIEW)
Mahamathojayeva, H. B., Nabiyeva, D. A., Zaharova, S. B., & Akhmadjonova, M. A. (2023) · Eurasian Journal of Medical and Natural Sciences · doi:10.37547/ejmns-v03-i02-p1-22
Update on hidradenitis suppurativa
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Saaiq, M. (2023) · Annals of Medical and Surgical Dermatology · doi:10.61577/amsd.2023.100002
Immunomodulators and Biologics for Follicular and Neutrophilic Cutaneous Disorders
Masood, M., & Hamzavi, I. H. (2024) · Springer eBooks · doi:10.1007/978-3-031-66590-5_10
Hidradenitis suppurativa: latest insights on the etiology, pathogenesis and features of therapy
Svechnikova, E. V. S., & Zhufina, S. Е. (2024) · Meditsinskiy sovet = Medical Council · doi:10.21518/ms2024-351
Hidradenitis Suppurativa Biomarkers
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Advancing the Management of Hidradenitis Suppurativa: Emerging Therapies and Current Best Practices
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Reddy, S., Beckham, C. J., Kapur, S. K., Nguyen, K. T., Sidhu, K. S., Alam, Z., Verma, K. K., Friedmann, D. P., Burkhart, C. G., & Tarbox, M. B. (2026) · Cureus · doi:10.7759/cureus.103110
Hidradenitis supurativa: tratamiento con agentes biológicos y moléculas pequeñas
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Hidradenitis Suppurativa Presenting with Ocular Manifestations in a 44-Year-Old Male: A Case Report
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Aleshin, M. A., Tran, T., Pansar, I., Shang, A., Friesen, D., & Kimball, A. B. (2026) · Drugs - Real World Outcomes · doi:10.1007/s40801-026-00564-8
- Authors
- Markota Čagalj, A., Marinović, B., & Bukvić Mokos, Z.
- Affiliations
- Department of Dermatology and Venereology, University Hospital Centre Split, Spinčićeva 1, 21000 Split, Croatia
- University Hospital Centre Zagreb (HR)
- School of Medicine, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia
- Venue
- International Journal of Molecular Sciences
- Publisher
- MDPI AG
- Published
- 2022-03-29
- Volume
- 23
- Issue
- 7
- Pages
- 3753
- ISSN
- 1422-0067 (ISSN-L)
- PMC
- PMC8998913
- OpenAlex
- W4220871749
- Cited by
- 74
- References
- 163
- Citations by year
- 2026: 9 · 2025: 17 · 2024: 26 · 2023: 19 · 2022: 3
- FWCI
- 2.89
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Molecular Sciences (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Dermatology › Hidradenitis Suppurativa and Treatments
- Health Sciences › Medicine › Epidemiology › Autoimmune and Inflammatory Disorders
- Health Sciences › Medicine › Rheumatology › Osteomyelitis and Bone Disorders Research
- Keywords
- hidradenitis suppurativa, targeted therapy, biologic therapy, TNF-alpha inhibitors, adalimumab, IL-17, interleukin-1, IL-12/23, anti-IL-17 antibody, secukinumab, bimekizumab, inflammatory cytokines
- MeSH terms
- Adalimumab, Tumor Necrosis Factor Inhibitors, Adolescent, Adult, Humans, Tumor Necrosis Factor-alpha, Hidradenitis Suppurativa, Interleukin-12
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