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Review
. 2025 Apr;43(2):231-245.
doi: 10.1016/j.det.2024.12.008. Epub 2025 Jan 21.

Managing Hidradenitis Suppurativa with Biologics and Small Molecule Inhibitors

Victoria Fang  1 , Radhika Gupta  2 , Robert G Micheletti  3
Affiliations
Review

Managing Hidradenitis Suppurativa with Biologics and Small Molecule Inhibitors

Victoria Fang et al. Dermatol Clin. 2025 Apr.

Abstract

"Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with a significant quality-of-life impact. In addition to the 2 drugs approved by the Food and Drug Administration for HS, adalimumab and secukinumab, several other biologic and small molecule inhibitors are used off-label or are in clinical trials. A systematic and evidence-based approach using these and other therapies-considering patient comorbidities, response to therapy, dose adjustment, and frequent troubleshooting-is required. In this article, we review the latest evidence supporting anti-inflammatory biologic and small molecule therapies for HS and provide a practical, algorithmic approach to management incorporating experience and expert opinion."

Keywords: Biologic; Biosimilar; Hidradenitis suppurativa; IL-1; IL-12/23; IL-17; JAK; Small molecule inhibitor; TNF.

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Conflict of interest statement

Disclosures R.G. Micheletti: reports research funding from Amgen, United States, Boehringer Ingelheim, United States, Cabaletta Bio, United States, and InflaRx, Germany; consultant for Vertex. V. Fang, R. Gupta: nothing to disclose.

MeSH terms