Building Hidradenitis Suppurativa Treatment Plan: Evaluating Standard of Care Pharmacotherapies

EP: 1.Recognizing Hidradenitis Suppurativa: From First Signs to an Accurate Diagnosis

EP: 2.Hidden in Plain Sight: Strategies to Improve Early Identification of Hidradenitis Suppurativa

EP: 3.The Pharmacist Advantage: Bridging Gaps in Hidradenitis Suppurativa Care

EP: 4.Health Equity in Hidradenitis Suppurativa: Addressing Care Disparities

EP: 5.Proactive Hidradenitis Suppurativa Management: From Watchful Waiting to Active Intervention

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EP: 6.Building Hidradenitis Suppurativa Treatment Plan: Evaluating Standard of Care Pharmacotherapies

There is a broad range of interventions available for managing this complex disease, making care coordination essential for patients. Coordinating treatments helps address not only the clinical aspects but also financial toxicity and the overall care experience. This ensures patients receive comprehensive support tailored to their unique needs.

Pharmacological treatment typically begins with noninvasive options such as topical or oral antibiotics, often tetracycline-based, as a first-line approach. Monitoring disease progression closely is crucial, with the goal of not waiting for the condition to worsen before escalating care. When initial therapies prove ineffective, and no contraindications exist, early initiation of biologic therapies becomes important. Challenges can arise, including adverse effects and insurance-driven step therapy requirements. Selecting the right treatment for the individual is key, balancing conventional options with newer biologic agents like anti-TNF and interleukin inhibitors, which have shown promising results and generally offer a better safety profile.

Deciding how to sequence these therapies requires careful assessment, as predicting disease progression remains difficult. Frequent early visits help evaluate both the clinical presentation and the patient’s quality of life, since visible skin symptoms can significantly impact daily functioning and social interactions. While severity scoring systems exist, many clinicians rely on experience and patient input to guide treatment decisions. For moderate to severe cases, it is appropriate to use the most effective therapies available to control the disease and improve outcomes. Additionally, hormonal treatments may benefit some patients, particularly females with hormonal triggers. Ultimately, treatment plans should be personalized, proactive, and based on the best available evidence to ensure patients receive timely and effective care throughout their disease journey.