The treatment landscape for hidradenitis suppurativa (HS) is evolving with the emergence of new therapies targeting the IL-17 pathway. Experts highlight bimekizumab and secukinumab as promising options, alongside innovative nanobody delivery methods, offering hope for improved patient outcomes. These advancements address the limitations of existing treatments like adalimumab, which often fail to halt disease progression in many patients.
IL-17 Inhibitors: A New Wave of HS Treatments
Raj Chovatiya, MD, PhD, highlighted the significance of anti-IL17 therapies at the Maui Derm NP+PA Fall 2024 conference. Bimekizumab, an IL-17 A and F blocker already approved for psoriasis, is anticipated to receive approval for HS soon. "Bimekizumab we have for psoriasis and we'll have for (hidradenitis suppurativa) very soon," Chovatiya noted, emphasizing the "very exciting data" supporting its use in HS.
Secukinumab's Approval and Clinical Trial Data
Secukinumab, an anti-IL17A biologic drug, has already been approved for HS. Data from the SUNSHINE and SUNRISE trials demonstrated secukinumab's superiority over placebo at various dosing intervals. According to Chovatiya, "What they showed very clearly at a couple of dosing intervals was that there was superiority of secukinumab versus placebo itself...in the case of these phase 3 trials, secukinumab very clearly got to where we needed to in terms of a high score of 50."
Nanobody Delivery Systems
In addition to traditional antibodies, innovative nanobody delivery systems targeting IL-17 A and F are being explored. These smaller molecules offer potentially better penetration, enhancing treatment efficacy. Chovatiya explained, "There's some data there, both in terms of IL-17 A and F blockade, essentially innovative ways of delivering molecules that are not exactly antibodies, but smaller, therefore they have better penetration."
Addressing Unmet Needs in HS Treatment
Adalimumab, while beneficial, has proven to be an imperfect solution for all HS patients. The disease often progresses despite treatment, underscoring the need for more effective therapies. The approval of secukinumab and the ongoing development of other anti-IL-17 therapies represent significant steps forward. "Adalimumab was amazing for all of us, but I think we've known that it isn't the perfect solution for every single patient with HS," Chovatiya stated. "So really, with the approval of secukinumab, you should, hopefully every year, be seeing something really exciting. If not a therapy getting approved, a phase three data point coming out."
