The Effect of Subcutaneous Brodalumab upon Clinical Disease Activity in Hidradenitis Suppurativa: An Open Label Cohort Study.

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Hidradenitis Suppurativa is an autoinflammatory disorder of keratinization, with dysregulation of Th17 cytokines. Brodalumab is a monoclonal antibody which targets the IL-17RA receptor.To assess safety and tolerability and clinical response at Week 12 & 24 of Brodalumab in moderate-to-severe HS. 10 participants with no history of inflammatory bowel disease were administered Brodalumab 210mg/1.5mL subcutaneously at Weeks 0, 1 and 2 and every 2 weeks thereafter until Week 24. Participants were assessed for adverse events (grade 2/3 adverse events) and clinical response (HiSCR, Sartorius, IHS4) including ultrasound and skin biopsies.All 10 Participants completed the study. No grade 2/3 adverse events associated with the use of Brodalumab were reported. 100% patients achieved HiSCR and 80% achieved IHS4 category change at Week 12. HiSCR achievement occurred as early as Week 2, likely due to the unique blockade of IL-17A, IL-17C and IL-17F by Brodalumab. Significant improvements were seen in pain, itch, quality of life and depression.Brodalumab was well tolerated in this HS cohort with no serious adverse events and rapid improvement in clinical outcomes. Alterations in dose frequency may be required in those with advanced disease which requires further exploration.

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