A new international study is offering real-world evidence for using biologic therapy in hidradenitis suppurativa (HS), showing that the treatment approach not only improves skin symptoms but may also reduce systemic inflammation, reflected in improvements to lipid profiles.1
This study adds to growing evidence that biologic therapy for HS offers dual benefits for the chronic
With these findings, the researchers emphasize that by combining skin assessments with routine metabolic monitoring, clinicians may better track treatment success and improve long-term outcomes for patients living with the condition.
Publishing their findings in the Australasian Journal of Dermatology, the group followed 24 adults with moderate-to-severe HS from 2 dermatology centers in Italy and Australia over a 2-year period. All patients included in the study had previously failed conventional systemic therapies and most had not previously received a biologic. Approved biologics for the treatment of HS include
Patients were evaluated at baseline, 24 weeks, 52 weeks, and 104 weeks. Disease activity was measured using validated clinical scores such as the International HS Severity Score System (IHS4) and the HS Investigator Global Assessment (HS-IGA). Researchers also monitored fasting lipid profiles—cholesterol and triglycerides—as markers of systemic inflammation.1
By week 24, patients were categorized as early responders (IHS4 ≤10) or late responders (IHS4 ≥11). Early responders showed marked and sustained improvements in lesion counts, abscesses, and scarring through week 104. Late responders, by contrast, demonstrated more modest benefits.
Baseline disease severity appeared to influence response. For example, patients who started treatment later or who had more advanced HS were less likely to achieve rapid or profound improvements. This finding, wrote the researchers, reinforces the importance of early diagnosis and treatment to prevent progression to severe, scarring disease.
One of the most novel aspects of the study was its focus on lipid metabolism. Early responders showed reductions in total cholesterol and triglycerides over time, which were maintained through the 2-year follow-up. While these changes did not reach statistical significance (P > 0.05), likely due to the small sample size, they suggest a systemic anti-inflammatory effect of biologic therapy.
Chronic inflammation is known to promote atherosclerosis and dyslipidemia. Improvements in lipid levels mirror findings from psoriasis and rheumatoid arthritis, where biologics have been associated with reduced cardiovascular risk. The researchers suggest that lipid monitoring could serve as a simple, inexpensive tool to track systemic treatment benefits in HS.
“Lipid tests are cheap, widely available and easy to interpret in clinical practice,” explained the researchers. “Integrating lipid tests into HS management could provide clinicians with more information on the systemic effects of the treatment. Monitoring lipid levels along with clinical scores may help identify patients who are not only improving clinically on the skin but also reducing body-wide inflammation.”
Routine lipid testing, the authors argue, could help dermatologists and primary care physicians monitor treatment response and identify patients at greater risk of cardiovascular complications.
The group acknowledged the study’s small sample size and two-center design as limitations. Larger, multicenter trials with control groups will be needed to confirm the findings and determine whether improved lipid levels translate into fewer heart attacks, strokes, or long-term survival benefits.
Future studies should also incorporate broader biomarkers of inflammation, such as C-reactive protein and cytokine profiles, to fully capture systemic effects.
References
- Ingurgio RC, Alfano A, Matteodo E, et al. Effectiveness of biologic therapy in hidradenitis suppurativa: real-world clinical outcomes and lipid profile evaluation. Australas J Dermatol. Published online August 26, 2025. doi:10.1111/ajd.14592
- AbbVie’s Humira (adalimumab) receives first and only U.S. Food and Drug Administration approval for moderate to severe hidradenitis suppurativa. AbbVie. News release. Published September 10, 2015. Accessed September 19, 2025.
https://news.abbvie.com/2015-09-10-AbbVies-HUMIRA-Adalimumab-Receives-First-and-Only-U-S-Food-and-Drug-Administration-Approval-for-Moderate-to-Severe-Hidradenitis-Suppurativa - FDA approves Novartis Cosentyx as the first new biologic treatment option for hidradenitis suppurativa patients in nearly a decade. Novartis. News release. Published October 31, 2023. Accessed September 19, 2025.
https://www.novartis.com/news/media-releases/fda-approves-novartis-cosentyx-first-new-biologic-treatment-option-hidradenitis-suppurativa-patients-nearly-decade - UCB receives U.S. FDA approval for Bimzelx (bimekizumab-bkzx) as the first IL-17A and IL-17F inhibitor for adults with moderate-to-severe hidradenitis suppurativa. UCB Pharma. News release. Published November 20, 2024. Accessed September 19, 2025.
https://www.ucb-usa.com/stories-media/UCB-U-S-News/detail/article/ucb-receives-us-fda-approval-for-bimzelxr-bimekizumab-bkzx-as-the-first-il-17a-and-il-17f-inhibitor-for-adults-with-moderate-to-severe-hidradenitis-suppurativa