An open-label study of anakinra for the treatment of moderate to severe hidradenitis suppurativa

Background Hidradenitis suppurativa (HS) is a chronic inflammatory disorder characterized by sterile abscesses and fistulae predominantly affecting the axillae and groin. Various biologic agents have been attempted for HS, but there is still no definitive treatment. Objectives We sought to evaluate the efficacy, safety, and tolerability of anakinra in the treatment of moderate to severe HS. Methods Six patients with moderate to severe HS were enrolled in an open-label study with all patients receiving active treatment for 8 weeks with an additional 8 weeks of follow-up off therapy. Results The 5 patients who completed the 8-week therapy showed a significant mean decrease in their modified Sartorius score of 34.8 points. The physician and patient global assessment of overall activity showed significant reductions between baseline and 8 weeks of therapy: 45.8 points and 35.6 points, respectively. The Dermatology Life Quality Index showed a significant reduction after 8 weeks of treatment with anakinra. Functional T-cell analysis revealed that patients had increased percentages of CD3⁺ T cells in lesional skin compared with nonlesional skin before therapy. Limitations The limited number of patients and lack of control group are limitations. Conclusions Anakinra demonstrated decreased HS disease activity by both objective and subjective measures.