Analysis of the Efficacy and Safety of Secukinumab Combined with Surgical Treatment for Hidradenitis Suppurativa: A Real-World Retrospective Study in China

Abstract

Purpose: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder. The IL-17A antagonist secukinumab has shown promising efficacy in international clinical trials; however, real-world evidence from China remains limited. This study evaluates the effectiveness and safety of secukinumab combined with surgical intervention for treating severe HS in a Chinese cohort. Patients and Methods: A retrospective analysis of 21patients with HS admitted to our hospital from May 2023 to August 2024 was conducted. The patients received combination therapy consisting of secukinumab and palliative surgery. The primary efficacy endpoint was the proportion of patients achieving Hidradenitis Suppurativa Clinical Response (HiSCR50) at week 16. Secondary endpoints included HiSCR50 response rates at weeks 32 and 48, changes in the International Hidradenitis Suppurativa Severity Score System (IHS4), Visual Analog Scale (VAS) scores for pain, Dermatology Life Quality Index (DLQI) scores, and the incidence of adverse events at weeks 16, 32, and 48. Results: At week 16, the HiSCR50 response rate was 76.2% (16/21), accompanied by a significant 71.3% reduction in the IHS4 score from baseline (P < 0.001). Both the DLQI and VAS scores demonstrated notable decreases of 44.2% and 43.7% (P < 0.001 for both). By week 48, sustained improvements were observed in HiSCR50 response, IHS4 score, DLQI, and VAS scores, with reduction rates of 75.2%, 57.1%, and 65.3%. Only one patient reported mild eczema, and no serious adverse events were documented. Conclusion: Secukinumab in combination with surgical intervention rapidly and significantly improves clinical symptoms, quality of life, and pain levels in Chinese patients with moderate-to-severe HS, while demonstrating a favorable safety profile. This combined therapeutic approach may represent a novel treatment option for severe HS; however, further validation through large-scale, multicenter studies is warranted.