AT A GLANCE

This living systematic review analyzed 26 randomized trials involving over 5,700 patients to evaluate treatment outcomes across 39 therapeutic arms. Several agents—including both established and investigational therapies—demonstrated superior efficacy to placebo with favorable safety profiles, offering a comparative framework to inform evidence-based care in HS.

In the evolving treatment landscape of moderate to severe hidradenitis suppurativa (HS), comparative evidence has remained scarce—particularly for emerging therapies. To address this gap, researchers conducted a living systematic review and network meta-analysis to synthesize head-to-head efficacy and safety data across a wide array of interventions. Drawing from 26 randomized phase 2 and 3 trials encompassing 5767 patients and 39 treatment arms, the study employed HiSCR-50 and HiSCR-75 as efficacy endpoints, alongside safety measures including serious adverse events and treatment discontinuation.

The analysis revealed that multiple biologics and investigational agents—such as sonelokimab, lutikizumab, adalimumab, bimekizumab, povorcitinib, and secukinumab—outperformed placebo in achieving HiSCR-50, with safety profiles largely comparable or superior to placebo controls. Importantly, the review offers a rigorous comparative framework for clinical decision-making, especially in light of the limited availability of direct comparative trials. This dynamic, continually updated synthesis provides clinicians and researchers with an essential reference point for optimizing therapeutic strategies in HS.

"These findings provide a comprehensive comparative framework to guide treatment selection in HS, supporting evidence-based use of both approved and pipeline therapies in the absence of direct head-to-head trials," write the authors.

Reference: Garg A, Cohn E, Midgette B, Frasier K, Strunk A. Efficacy and Safety of Medical Interventions for Moderate to Severe Hidradenitis Suppurativa: A Living Systematic Review and Network Meta-Analysis. JAMA Dermatol. Published online July 2, 2025. doi:10.1001/jamadermatol.2025.1976