From the Guidelines
Long-term steroid dosage for Hidradenitis suppurativa is not recommended as the provided evidence does not support the use of steroids as a long-term treatment option for this condition.
Treatment Options
Instead, the evidence suggests the following treatment options:
- Topical Clindamycin 1% solution/gel b.i.d. for 12 weeks or Tetracycline 500 p.o. b.i.d. for 4 months for mild disease 1
- Clindamycin 300 p.o. b.i.d. with Rifampicin 600 p.o. o.d. for 10 weeks for more widespread disease or moderate-to-severe disease 1
- Adalimumab 160 mg at week 0,80 mg at week 2; then 40 mg subcutaneously weekly for patients who do not respond to previous treatments 1
Key Considerations
- Treatment should be based on the evaluation of the inflammatory components as well as the scarring and should be directed by evidence-based guidelines 1
- Surgery may be necessary for patients with significant scarring or those who do not respond to medical treatment 1
- Patient-reported outcomes, such as DLQI, itch and pain assessment, should be routinely used to assess treatment response 1
From the Research
Long-term Steroid Dosage for Hidradenitis Suppurativa
There is limited information available on the recommended long-term steroid dosage for Hidradenitis suppurativa. However, the following points can be noted:
- The studies provided do not specifically mention steroid dosage, but rather focus on the use of adalimumab, a tumor necrosis factor-α (TNF-α) antagonist, for the treatment of hidradenitis suppurativa 2, 3, 4, 5.
- Adalimumab has been shown to be effective in the long-term treatment of moderate-to-severe hidradenitis suppurativa, with a recommended dosage of 40 mg every week 3, 5.
- Some studies suggest that dose intensification to 80 mg/week may be beneficial for patients who do not respond sufficiently to the standard dose of 40 mg/week 4.
- The optimal long-term dosing strategy for adalimumab in hidradenitis suppurativa is continuous weekly dosing, as it has been shown to maintain response and improve outcomes 3, 5.
Key Findings
- Adalimumab is a suitable treatment option for long-term control of moderate-to-severe hidradenitis suppurativa 2, 3, 5.
- Continuous weekly dosing with adalimumab 40 mg is a reasonable treatment option for long-term control of moderate-to-severe hidradenitis suppurativa 3.
- Dose intensification to 80 mg/week may be beneficial for patients who do not respond sufficiently to the standard dose of 40 mg/week 4.
Treatment Considerations
- The treatment of hidradenitis suppurativa should be individualized, taking into account the severity of the disease and the patient's response to treatment 6.
- A therapeutic algorithm informed by the evidence available at the time of the review can be used to guide treatment decisions 6.
- Patients who do not show at least a partial response to weekly adalimumab by week 12 are unlikely to benefit from continued therapy 5.