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Safety and Efficacy of Adalimumab (Humira) for Hidradenitis Suppurativa (HS) Peri-Surgically

Phase 4
Completed
Conditions
Hidradenitis Suppurativa (HS)
Interventions
Drug: Placebo
Registration Number
NCT02808975
Lead Sponsor
AbbVie
Brief Summary

The objective of this study was to assess the safety and efficacy of adalimumab prior to surgery in participants with moderate to severe Hidradenitis Suppurativa (HS) who were surgical candidates.

Detailed Description

This was an interventional, randomized, double-blind (DB), placebo-controlled study. The study duration included a 30-day Screening Period, an initial 12-week DB treatment pre-surgery period (Period A), a 2-week peri-operative period with continuation of weekly DB study drug administration (Period B), and a subsequent 10-week DB treatment post-operative period (Period C). Randomization (in a 1:1 ratio) in Period A was stratified by baseline Hurley Stage (II versus III) and anatomical location of the planned surgical site (i.e., axilla versus inguinal region). The projected size of the surgical excision established by the designated surgeon during the Screening Period (calculated from a tracing of the outer perimeter onto an acetate sheet or equivalent) was recorded. In Period B, the designated surgeon measured and recorded the surface area of the actual surgery, with surgery occurring during Week 13. Surgery and post-operative management (e.g., hospitalization, surgical wound care) was per local practice. No study drug was administered at Week 24, the final study visit. Participants were able to begin commercial product (as prescribed by the participants's physician) after all Week 24 procedures were completed.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
206
Inclusion Criteria
  • Participant must have skin lesions that are diagnostic of Hidradenitis Suppurativa (HS) for at least 1 year (365 days) prior to the Baseline visit

  • Participant must have at least 3 distinct anatomical regions involved with inflammatory (also termed 'active') HS lesions; plus

    • either one axilla or one inguinal region (limited to the inguino-crural fold and adjacent areas) that requires excisional surgery, and
    • with at least one of the other affected HS regions (e.g., contralateral inguinal region, buttocks, inframammary region) rated as Hurley Stage II or III
  • Participant must have a total abscess and inflammatory nodule (AN) count of greater than or equal to 3 at the Baseline visit within the HS non-surgical sites

  • The HS surgical site must contain at least one active HS lesion

  • The HS surgical site must require excisional surgery and is large enough to require healing by secondary intention as assessed by the designated surgeon

Exclusion Criteria
  • Participant has a draining fistula count of greater than 20 at the Baseline visit
  • Participant requires surgery at any anatomical site other than an unilateral axilla or inguinal region site
  • Participant requires surgical management prior to Week 13
  • Participant requires, based on the designated surgeon's assessment, excisional surgery with primary closure as the method of closure being most beneficial for the participant

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboPeriod A: Day 1- 4 subcutaneous (SC) injections; Week 2- 2 SC injections; Weeks 4-12- 1 SC injection each week Period B: Weeks 13-14- 1 SC injection each week Period C: Weeks 15-23- 1 SC injection each week
AdalimumabAdalimumabPeriod A: Day 1- 4 subcutaneous (SC) 40 mg injections; Week 2- 2 SC 40 mg injections; Weeks 4-12- 1 SC 40 mg injection each week Period B: Weeks 13-14- 1 SC 40 mg injection each week Period C: Weeks 15-23- 1 SC 40 mg injection each week
Primary Outcome Measures
NameTimeMethod
Percentage of Participants Achieving Hidradenitis Suppurativa Clinical Response (HiSCR) at Week 12At Week 12

HiSCR is defined as at least a 50% reduction in the abscess and inflammatory nodule (AN) count with no increase in abscess count and no increase in draining fistula count relative to Baseline.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants Achieving HiSCR-es at Week 12At Week12

Hidradenitis Suppurativa Clinical Response-es (HiSCR-es) is defined as at least a 50% reduction in the abscess and inflammatory nodule (AN) count with no increase in abscess count and no increase in draining fistula count relative to Baseline, excluding the Hidradenitis Suppurativa surgical site.

Percentage of Participants Achieving HiSCR-es at Week 24At Week 24

Hidradenitis Suppurativa Clinical Response-es (HiSCR-es) is defined as at least a 50% reduction in the abscess and inflammatory nodule (AN) count with no increase in abscess count and no increase in draining fistula count relative to Baseline, excluding the Hidradenitis Suppurativa surgical site.

Percent Change in the Surface Area of the Hidradenitis Suppurativa (HS) Surgical Site From Baseline to Week 12From Baseline to Week 12

The projected size of the surgical excision established by the designated surgeon during the Screening Period (calculated from a tracing of the outer perimeter onto an acetate sheet or equivalent) was recorded by the study physician. The change in the surface area of the projected HS surgical site from Baseline to Week 12 was documented.

Percentage of Participants at Week 12 That Require a Less Extensive Surgery Than the Surgical Plan (Determined at Baseline) or No SurgeryAt Week 12

The projected size of the surgical excision established by the designated surgeon during the Screening Period (calculated from a tracing of the outer perimeter onto an acetate sheet or equivalent) was recorded by the study physician. The change in the surface area of the projected HS surgical site from Baseline to Week 12 was documented, and the percentage of participants at Week 12 requiring a less extensive surgery than the surgical plan (determined at Baseline) or no surgery as determined by the designated surgeon was recorded.

Trial Locations

Locations (55)

Beth Israel Deaconess Medical Center /ID# 168438

🇺🇸

Boston, Massachusetts, United States

UZ Gent /ID# 150906

🇧🇪

Gent, Oost-Vlaanderen, Belgium

NewLab Clinical Research Inc. /ID# 151315

🇨🇦

St. John's, Newfoundland and Labrador, Canada

Hospital Pablo Tobon Uribe /ID# 152693

🇨🇴

Medellín, Colombia

Hospital Universitario Dr. Jose Eleuterio Gonzalez /ID# 151027

🇲🇽

Monterrey, Nuevo Leon, Mexico

King Faisal Specialist Hospital and Research Centre /ID# 153769

🇸🇦

Riyadh, Najran, Saudi Arabia

Fundacion Valle Del Lili /ID# 151565

🇨🇴

Cali, Colombia

Haukeland University Hospital /ID# 152662

🇳🇴

Bergen, Hordaland, Norway

Prywatny Osrodek Chirurgii Plastycznej Andrzej Bieniek /ID# 169413

🇵🇱

Wrocław, Dolnoslaskie, Poland

Centro Hospitalar de Sao Joao, EPE /ID# 150885

🇵🇹

Porto, Portugal

Spitalul Universitar de Urgenta Elias /ID# 151072

🇷🇴

Bucharest, Bucuresti, Romania

Radboud Universitair Medisch Centrum /ID# 152157

🇳🇱

Nijmegen, Gelderland, Netherlands

Fakult Nem Kralovske Vinohrady /ID# 169173

🇨🇿

Prague, Czechia

Klinikum Ruhr Univ Bochum /ID# 150873

🇩🇪

Bochum, Germany

Klinikum Darmstadt GmbH /ID# 150874

🇩🇪

Darmstadt, Germany

Staedtisches Klinikum Dessau /ID# 150876

🇩🇪

Dessau, Germany

A.O.U Sant'Anna di Ferrara /ID# 150066

🇮🇹

Ferrara, Italy

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico /ID# 150069

🇮🇹

Milan, Lombardia, Italy

Policlinico Univ Tor Vergata /ID# 150142

🇮🇹

Rome, Italy

Universita degli Studi di /ID# 150068

🇮🇹

Modena, Italy

Erasmus Medisch Centrum /ID# 150672

🇳🇱

Rotterdam, Netherlands

NW State Med Univ NA Mechnikov /ID# 151197

🇷🇺

St. Petersburg, Russian Federation

Spitalul Municipal de Urgenta Timisoara /ID# 151073

🇷🇴

Timişoara, Timis, Romania

Corporac Sanitaria Parc Tauli /ID# 150789

🇪🇸

Sabadell, Barcelona, Spain

City Clinical Hospital 15 /ID# 151281

🇷🇺

Moscow, Russian Federation

Hospital Santa Creu i Sant Pau /ID# 152742

🇪🇸

Barcelona, Spain

Hospital General Universitario Gregorio Maranon /ID# 150788

🇪🇸

Madrid, Spain

Hospital de Manises /ID# 150790

🇪🇸

Manises, Spain

Uludag University Medical Faculty /ID# 150831

🇹🇷

Bursa, Turkey

Karolinska Univ Sjukhuset /ID# 150817

🇸🇪

Solna, Sweden

Hacettepe University Medical Faculty /ID# 150829

🇹🇷

Ankara, Turkey

Whipps Cross Univ Hospital /ID# 151699

🇬🇧

London, London, City Of, United Kingdom

Hospital Univ Germans Trias I Pujol /ID# 150787

🇪🇸

Badalona, Spain

Wallace Medical Group, Inc. /ID# 171289

🇺🇸

Beverly Hills, California, United States

Encino Research Center / T. Jo /ID# 171347

🇺🇸

Encino, California, United States

CUB Hospital Erasme /ID# 150907

🇧🇪

Brussels, Bruxelles-Capitale, Belgium

Penn State Hershey Medical Ctr /ID# 168447

🇺🇸

Hershey, Pennsylvania, United States

Rhode Island Hospital /ID# 168439

🇺🇸

Providence, Rhode Island, United States

York Dermatology Clinic and Research Centre /ID# 151314

🇨🇦

Richmond Hill, Ontario, Canada

Fakultni nemocnice Ostrava /ID# 169174

🇨🇿

Ostrava, Praha 5, Czechia

Bispebjerg Hospital /ID# 150796

🇩🇰

Copenhagen NV, Hovedstaden, Denmark

Sjaellands Universitets Hospit /ID# 150795

🇩🇰

Roskilde, Sjælland, Denmark

Charité Universitätsmedizin Campus Mitte /ID# 150875

🇩🇪

Berlin, Germany

University General Hospital Attikon /ID# 150841

🇬🇷

Athens, Attiki, Greece

Genl Hospital Andreas Syggros /ID# 150842

🇬🇷

Athens, Greece

St Vincent's University Hosp /ID# 150043

🇮🇪

Dublin, Ireland

Genl Hospital Andreas Syggros /ID# 150840

🇬🇷

Athens, Greece

Universitair Medisch Centrum Groningen /ID# 150662

🇳🇱

Groningen, Netherlands

Universitaetsklinikum Erlangen /ID# 167251

🇩🇪

Erlangen, Bayern, Germany

Polyclinique Courlancy /ID# 157761

🇫🇷

Reims, France

University of California Irvine /ID# 170054

🇺🇸

Irvine, California, United States

Hopital Prive d'Antony /ID# 157347

🇫🇷

Antony, Ile-de-France, France

University of Michigan Hospitals /ID# 200667

🇺🇸

Ann Arbor, Michigan, United States

Tulane Univ /ID# 168441

🇺🇸

New Orleans, Louisiana, United States

Univ NC Chapel Hill /ID# 168446

🇺🇸

Chapel Hill, North Carolina, United States

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