Effectiveness of Secukinumab in Patients With Moderate to Severe Hidradenitis Suppurativa: Results From a Meta-Analysis

OBJECTIVES: Hidradenitis suppurativa (HS) is a chronic inflammatory disease with a major impact on patients’ quality of life. Evidence published using real world data demonstrated the effectiveness of secukinumab in patients with moderate to severe HS previously treated with anti-tumor necrosis factor (TNF)-α. Although the evidence is consistent amongst studies, the number of patients enrolled in each study is relatively small. The objective of this analysis is to evaluate the effectiveness of secukinumab in patients with moderate to severe HS who failed or presented contraindications to anti-TNF-α.

METHODS: We conducted a scoping review with meta-analysis, searching two electronic databases (PubMed and Ovid) for observational studies on the effectiveness of secukinumab in patients with moderate to severe HS who failed or presented contraindications to anti-TNF-α treatment. The search and extraction were conducted in June 2024. The primary outcome was the achievement of Hidradenitis Suppurativa Clinical Response (HiSCR) at week 16. Two authors independently selected studies and extracted data for analysis. A proportional meta-analysis was conducted for calculation of a pooled result using a fixed-effects model with a CI_95%. The analysis was conducted in R, version 4.4.1, package ‘meta’.

RESULTS: A total of four studies published between 2021 and 2024 were included in the meta-analysis, involving a total of 119 patients, more than half (57%) were female. The estimated rate of HiSCR at week 16 was 45%, CI_95% [36%;55%]. The heterogeneity was I²=74% (p<0.01).

CONCLUSIONS: Our analysis reinforces the results on the effectiveness of secukinumab in HS patients who failed or presented contraindications to anti-TNF-α treatment. The pooled results are aligned with the results published in the SUNRISE and SUNSHINE studies, when comparing HiSCR data at week 16. Nevertheless, this analysis should be interpreted with caution, because of the limitations of the studies included, and further observational studies with larger sample size should be implemented.