Date of Award

2017

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Julie Solberg

Keywords

hidradenitis suppurativa; adalimumab; treatment

Abstract

Hidradenitis suppurativa is a chronic, recurrent follicular occlusion disease with painful, sometimes debilitating, cutaneous draining lesions and subcutaneous abscesses (DynaMed Plus, 2016). Hidradenitis suppurativa is understood to be a multifactorial disease that is hard to treat in some patients, especially those with a severe form of the disease. For this project, the efficacy of adalimumab for hidradenitis suppurativa was assessed and whether it is more beneficial than traditional treatments used. Adalimumab is a TNF-alpha inhibitor which belongs to the biologic DMARDs drug class. Kimball et al. (2012) found that at week 16 of their trial 3.9% of the placebo patients, 9.6% of every other week (EOW) dosing of adalimumab patients, and 17.6% of every week dosing of adalimumab patients achieved clinical response. Patient response reports on pain and outcomes were significantly greater in the weekly dosed patients vs. placebo group. A study by Miller et al. (2011) showed a significant reduction in Sartorious score after 6 weeks and an almost significant reduction seen after 12 weeks when compared to the placebo group (-10.7 vs. 7.5, P=0.024 and -11.3 vs. 5.8, P=0.07). Kimball et al. (2016) showed clinical response rates at week 12 were significantly higher for the groups receiving adalimumab weekly than for the placebo groups: 41.8% versus 26.0% in PIONEER I (P=0.003) and 58.9% versus 27.6% in PIONEER II (P

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