From the Guidelines
The dose of adalimumab (Humira) for the treatment of hidradenitis suppurativa is 40 mg weekly.
Key Points
- The initial dose is 160 mg at week 0,80 mg at week 2, and then 40 mg weekly starting at week 4 1.
- This dosing regimen is recommended for patients with moderate-to-severe HS who are unresponsive to conventional systemic therapy 1.
- The efficacy and safety of adalimumab for HS have been established in several clinical trials, including the PIONEER 1 and PIONEER 2 trials, which demonstrated significant improvements in HiSCR responses and quality of life measures 1.
- The use of adalimumab for HS is supported by guidelines from the British Association of Dermatologists and the North American Clinical Management Guidelines for Hidradenitis Suppurativa 1.
Important Considerations
- Patients should be monitored for treatment response using recognized instruments for pain and quality of life, including an inflammatory lesion count for those on adalimumab therapy 1.
- The treatment should be continued for at least 16 weeks to assess clinical response, and other treatment modalities should be considered if clinical response is not achieved 1.
From the FDA Drug Label
Two randomized, double-blind, placebo-controlled studies (Studies HS-I and II) evaluated the safety and efficacy of adalimumab in a total of 633 adult subjects with moderate to severe hidradenitis suppurativa (HS) with Hurley Stage II or III disease and with at least 3 abscesses or inflammatory nodules In both studies, subjects received placebo or adalimumab at an initial dose of 160 mg at Week 0,80 mg at Week 2, and 40 mg every week starting at Week 4 and continued through Week 11.
The dose of adalimumab (Humira) for the treatment of hidradenitis suppurativa is:
- Initial dose: 160 mg at Week 0
- Followed by: 80 mg at Week 2
- Maintenance dose: 40 mg every week starting at Week 4 2
From the Research
Adalimumab Dosing for Hidradenitis Suppurativa
The recommended dose of adalimumab (Humira) for the treatment of moderate-to-severe hidradenitis suppurativa (HS) is:
- 40 mg weekly or
- 80 mg every two weeks 3
Maintenance Dosing
Studies have shown that both maintenance dosing regimens (40 mg weekly or 80 mg every two weeks) can improve clinical severity and quality of life in patients with HS, with no significant difference between the two dosages 3, 4
Dose Intensification
Some studies have explored the effectiveness of adalimumab dose intensification in patients with recalcitrant HS or those who have lost response to the standard dose. Dose intensification to 80 mg/week has been shown to improve clinical outcomes in some patients 5, 6
Factors Influencing Response
Several factors can influence the response to adalimumab in patients with HS, including:
- Therapeutic delay (time from HS onset to adalimumab initiation) 7
- Previous treatments, such as immunosuppressants 7
- Patient characteristics, such as body mass index and smoking status 7
Clinical Response
Adalimumab has been shown to be effective in improving clinical response and quality of life in patients with HS, with significant reductions in disease severity and pain reported in several studies 3, 4, 7