Evaluation of medical and surgical treatments for hidradenitis suppurativa using real‐life data from the Scandinavian registry (HISREG)
Ø. Grimstad T. Tzellos D.N. Dufour Ø. Bremnes I.M. Skoie I. Snekvik E. Jarnæss A. Kyrgidis G. Ingvarsson
First published: 19 November 2018 https://doi.org/10.1111/jdv.15353 Cited by: 1
Conflict of Interest The other authors state no conflict of interest.
Funding source AbbVie paid for the extraction of data from the HISREG database and for the statistical analyses performed in this study. Thrasyvoulos Tzellos has received honorarium from AbbVie, and UCB. Øyvind Bremnes has received honorarium from Novartis. Elisabeth Jarnæss is an AbbVie employee and shareholder of AbbVie stocks. Athanassios Kyrgidis has received reimbursement for the conduct of the statistical analyses.
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Abstract
Background
Hidradenitis suppurativa (HS) substantially affects health‐related quality‐of‐life outcomes. Most treatment options are supported by low quality of evidence without validated outcomes.
Objective
The aim of this study was to evaluate the efficacy of surgical and medical interventions using physician‐ and patient‐reported outcomes registered in HISREG.
Methods
Data were extracted for all adult patients registered in HISREG between January 2013 and April 2016. Primary endpoints included Dermatology Life Quality Index (DLQI) scores, pain as measured using a numeric rating scale (NRS), Sartorius score and Hurley classification. Minimum clinically important differences (MCIDs) for DLQI and NRS pain were analysed. Secondary endpoints included comparisons among different treatment groups, safety and complications of various treatments.
Results
Two hundred and fifty‐five patients were included in the study: 31, 188, and 36 patients had Hurley stages I, II and III disease, respectively. Treatment with CO2 lasers was the most common treatment modality. One hundred and forty‐nine patients (58.4%) were treated with surgical intervention, 87 (34.1%) received antibiotics and/or anti‐inflammatory treatments, and 19 (7.5%) were treated with both surgery and medical intervention. No patients received biologic treatment. In patients with surgical treatments, Sartorius scores were significantly improved compared with baseline (P = 0.001), 83 patients (55%) achieved a DLQI MCID, and 75 patients (49.7%) achieved an NRS pain MCID. In patients with medical treatments, Sartorius scores were not significantly improved compared with baseline (P = 0.582); 25 patients (28%) achieved a DLQI MCID and 28 patients (31%) achieved an NRS pain MCID. In patients treated with surgical and medical combination, 9 (48%) achieved DLQI and NRS pain MCIDs and Sartorius scores were significantly improved.
Conclusions
CO2 laser treatment is more effective than the non‐biologic medical treatments in this analysis based on physician‐ and patient‐derived outcomes. The study provides limited evidence for the combination of medical and surgical therapies in patients with HS.
Citing Literature
Number of times cited according to CrossRef: 1
Pr. C.M.E. Rowland Payne, Hidradenitis suppurativa treatment – medical or surgical?, Journal of the European Academy of Dermatology and Venereology, 33, 6, (981-982), (2019).
Wiley Online Library
Ø. Grimstad T. Tzellos D.N. Dufour Ø. Bremnes I.M. Skoie I. Snekvik E. Jarnæss A. Kyrgidis G. Ingvarsson
First published: 19 November 2018 https://doi.org/10.1111/jdv.15353 Cited by: 1
Conflict of Interest The other authors state no conflict of interest.
Funding source AbbVie paid for the extraction of data from the HISREG database and for the statistical analyses performed in this study. Thrasyvoulos Tzellos has received honorarium from AbbVie, and UCB. Øyvind Bremnes has received honorarium from Novartis. Elisabeth Jarnæss is an AbbVie employee and shareholder of AbbVie stocks. Athanassios Kyrgidis has received reimbursement for the conduct of the statistical analyses.
Read the full text
ePDFPDFTOOLS SHARE
Abstract
Background
Hidradenitis suppurativa (HS) substantially affects health‐related quality‐of‐life outcomes. Most treatment options are supported by low quality of evidence without validated outcomes.
Objective
The aim of this study was to evaluate the efficacy of surgical and medical interventions using physician‐ and patient‐reported outcomes registered in HISREG.
Methods
Data were extracted for all adult patients registered in HISREG between January 2013 and April 2016. Primary endpoints included Dermatology Life Quality Index (DLQI) scores, pain as measured using a numeric rating scale (NRS), Sartorius score and Hurley classification. Minimum clinically important differences (MCIDs) for DLQI and NRS pain were analysed. Secondary endpoints included comparisons among different treatment groups, safety and complications of various treatments.
Results
Two hundred and fifty‐five patients were included in the study: 31, 188, and 36 patients had Hurley stages I, II and III disease, respectively. Treatment with CO2 lasers was the most common treatment modality. One hundred and forty‐nine patients (58.4%) were treated with surgical intervention, 87 (34.1%) received antibiotics and/or anti‐inflammatory treatments, and 19 (7.5%) were treated with both surgery and medical intervention. No patients received biologic treatment. In patients with surgical treatments, Sartorius scores were significantly improved compared with baseline (P = 0.001), 83 patients (55%) achieved a DLQI MCID, and 75 patients (49.7%) achieved an NRS pain MCID. In patients with medical treatments, Sartorius scores were not significantly improved compared with baseline (P = 0.582); 25 patients (28%) achieved a DLQI MCID and 28 patients (31%) achieved an NRS pain MCID. In patients treated with surgical and medical combination, 9 (48%) achieved DLQI and NRS pain MCIDs and Sartorius scores were significantly improved.
Conclusions
CO2 laser treatment is more effective than the non‐biologic medical treatments in this analysis based on physician‐ and patient‐derived outcomes. The study provides limited evidence for the combination of medical and surgical therapies in patients with HS.
Citing Literature
Number of times cited according to CrossRef: 1
Pr. C.M.E. Rowland Payne, Hidradenitis suppurativa treatment – medical or surgical?, Journal of the European Academy of Dermatology and Venereology, 33, 6, (981-982), (2019).
Wiley Online Library
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