JLE

European Journal of Dermatology

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Efficacy and tolerance of prolonged infliximab treatment of moderate-to-severe forms of hidradenitis suppurativa Volume 22, numéro 5, September-October 2012

Auteurs
Department of Dermatology,, Hospital Pharmacy, Department of Visceral Surgery, Hôpital Robert-Debré, CHU de Reims, Avenue du Général-Koenig, 51092 Reims, France

Hidradenitis suppurativa (HS) is a chronic suppurative disease impairing patients’ quality of life (QOL). The standard treatment remains extensive surgery; medical treatment is often disappointing. Objectives: Prolonged infliximab efficacy and tolerance in moderate-to-severe forms of HS were evaluated. Patients and methods: This prospective, monocentric, open, interventional study concerned patients with progressive, moderate-to-severe HS ineligible for surgery, or who relapsed after surgery. Infliximab (5 mg/kg) was infused at weeks 0, 2 and 6, and then every 4 weeks. When the response was satisfactory, infusion spacing was attempted. Results: Ten patients were included, 8 treated for 1 year, with a mean of 5 affected sites and 18 years of evolution. The mean initial DLQI was 20/30 (range 9-30). At 1 year, the number of involved sites ( P<0.001) and flares ( P<0.05) had decreased significantly under infliximab, as did HS severity. QOL improved clearly and rapidly for all patients, with mean DLQI at 6/30 ( P<0.001). Tolerance was satisfactory with only 4 minor infections, 1 keratoacanthoma and one rapidly resolving hepatitis. Conclusion: This evaluation of prolonged infliximab use in HS after surgical failure showed good efficacy and satisfactory tolerance without therapeutic escape during the first year of treatment.