{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T16:04:23Z","timestamp":1763568263318,"version":"3.45.0"},"reference-count":28,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:sec id=\"ab-doi250040-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Previous research suggests that patients with hidradenitis suppurativa (HS) may face a higher risk of serious infections compared with those with psoriasis. However, these studies are subject to limitations that could constrain their reliability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-doi250040-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the risk of hospitalization from noncutaneous infections, infection profiles, and the length of stay (LOS) of adult patients with HS and psoriasis treated with adalimumab.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-doi250040-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This retrospective cohort study was conducted using deidentified claims data from the MarketScan database. All adult patients with HS or psoriasis who initiated adalimumab therapy between January 2017 and December 2020 were included. Data were analyzed from October 2023 to March 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-doi250040-7\">\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>\n                      New users of adalimumab diagnosed with psoriasis or HS, identified using\n                      <jats:italic>International Statistical Classification of Diseases and Related Health Problems, Tenth Revision<\/jats:italic>\n                      codes and adalimumab prescriptions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-doi250040-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>The primary outcome was hospitalization from noncutaneous infections in a time-to-event analysis using inverse probability weighting to account for confounders in the Cox regression models. Secondary outcomes included the infection types compared using incidence rate ratios and LOS analyzed with multivariable Poisson regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-doi250040-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 10\u202f349 included patients, 5641 (54.5%) were female, and the mean (SD) age was 44.8 (12.8) years. The cohort included 1650 patients with HS and 8699 with psoriasis. The HS cohort was younger (mean [SD] age, 36.2 [11.5] years vs 46.5 [12.4] years) and predominantly female (1271 [77.0%] vs 4370 [50.2%]), with higher rates of obesity, Crohn disease, anxiety, and depression. The weighted Cox analysis indicated an increased risk of serious infection in patients with HS (hazard ratio, 1.53; 95% CI, 1.34-1.86). This group also had a higher likelihood of sepsis and genitourinary infections (sepsis: incidence rate ratio, 2.07; 95% CI, 1.35-3.12; genitourinary infections: incidence rate ratio, 2.22; 95% CI, 1.22-3.86) and greater odds of prolonged LOS (odds ratio, 1.28; 95% CI, 1.13-1.45) compared with the psoriasis cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-doi250040-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In this cohort study, among adults treated with adalimumab, those with moderate to severe HS had an elevated risk of infection and different infection profiles compared with those with psoriasis. Future research should focus on the impacts of disease severity and treatment regimens on infection risk and develop targeted prevention strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamadermatol.2025.2881","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T15:00:27Z","timestamp":1755702027000},"page":"1116","source":"Crossref","is-referenced-by-count":0,"title":["Risk of Serious Infection With Adalimumab in Hidradenitis Suppurativa Compared With Psoriasis"],"prefix":"10.1001","volume":"161","author":[{"given":"Bruna Galvao de Oliveira","family":"Wafae","sequence":"first","affiliation":[{"name":"Department of Dermatology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Beth Israel Deaconess Medical Center, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra P.","family":"Charrow","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Stein","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John S.","family":"Barbieri","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Associate Editor and Evidence-based Practice Editor, JAMA Dermatology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan H.","family":"Noe","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Sanofi Pharmaceuticals, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","reference":[{"issue":"5","key":"doi250040r1","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.1016\/j.jaad.2015.07.052","article-title":"Hidradenitis suppurativa: epidemiology and scope of the problem.","volume":"73","author":"Jemec","year":"2015","journal-title":"J Am Acad Dermatol"},{"issue":"4","key":"doi250040r2","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1007\/s13555-018-0264-z","article-title":"The comorbidity burden of hidradenitis suppurativa in the United States: a claims data analysis.","volume":"8","author":"Kimball","year":"2018","journal-title":"Dermatol Ther (Heidelb)"},{"issue":"9","key":"doi250040r4","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1001\/jamadermatol.2015.0718","article-title":"Risk of serious infection with biologic and systemic treatment of psoriasis: results from the Psoriasis Longitudinal Assessment and Registry (PSOLAR).","volume":"151","author":"Kalb","year":"2015","journal-title":"JAMA Dermatol"},{"issue":"9","key":"doi250040r5","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1001\/jamadermatol.2021.2599","article-title":"Association between biologics use and risk of serious infection in patients with psoriasis.","volume":"157","author":"Penso","year":"2021","journal-title":"JAMA Dermatol"},{"issue":"8","key":"doi250040r6","doi-asserted-by":"publisher","first-page":"1726","DOI":"10.1016\/j.jid.2018.01.039","article-title":"Risk of serious infection, opportunistic infection, and herpes zoster among patients with psoriasis in the United Kingdom.","volume":"138","author":"Takeshita","year":"2018","journal-title":"J Invest Dermatol"},{"issue":"6","key":"doi250040r7","doi-asserted-by":"publisher","first-page":"1135","DOI":"10.1016\/j.jaad.2010.08.036","article-title":"Increased risk of infectious disease requiring hospitalization among patients with psoriasis: a population-based cohort.","volume":"65","author":"Wakkee","year":"2011","journal-title":"J Am Acad Dermatol"},{"issue":"3","key":"doi250040r8","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1159\/000534575","article-title":"Infectious disease screening prior to systemic immunomodulatory therapy in hidradenitis suppurativa: consensus guidelines from the Asia-Pacific Hidradenitis Suppurativa Foundation.","volume":"240","author":"Kozera","year":"2024","journal-title":"Dermatology"},{"issue":"2","key":"doi250040r9","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1111\/bjd.18093","article-title":"Associations of cutaneous and extracutaneous infections with hidradenitis suppurativa in U.S. children and adults.","volume":"182","author":"Lee","year":"2020","journal-title":"Br J Dermatol"},{"issue":"4","key":"doi250040r10","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1016\/S1473-3099(13)70324-4","article-title":"Strengthening the Reporting of Molecular Epidemiology for Infectious Diseases (STROME-ID): an extension of the STROBE statement.","volume":"14","author":"Field","year":"2014","journal-title":"Lancet Infect Dis"},{"issue":"7","key":"doi250040r11","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1002\/pds.5229","article-title":"Validation of claims-based algorithms to identify patients with psoriasis.","volume":"30","author":"Lee","year":"2021","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"4","key":"doi250040r12","doi-asserted-by":"publisher","DOI":"10.2196\/38783","article-title":"Phenotype algorithms to identify hidradenitis suppurativa using real-world data: development and validation study.","volume":"5","author":"Hardin","year":"2022","journal-title":"JMIR Dermatol"},{"issue":"4","key":"doi250040r13","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1002\/pds.5401","article-title":"Validation of diagnosis codes to identify hospitalized COVID-19 patients in health care claims data.","volume":"31","author":"Kluberg","year":"2022","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"7","key":"doi250040r14","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1002\/pds.5253","article-title":"Validity of ICD-10-CM diagnoses to identify hospitalizations for serious infections among patients treated with biologic therapies.","volume":"30","author":"Lo Re","year":"2021","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"9","key":"doi250040r15","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1016\/j.rmed.2004.02.022","article-title":"Prospective evaluation of pneumonia severity index in hospitalised patients with community-acquired pneumonia.","volume":"98","author":"van der Eerden","year":"2004","journal-title":"Respir Med"},{"issue":"5","key":"doi250040r16","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation.","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis"},{"issue":"2","key":"doi250040r17","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1111\/ijd.16885","article-title":"Risk of infection in patients with hidradenitis suppurativa on biologics or other immunomodulators: a systematic review and meta-analysis.","volume":"63","author":"Lazaridou","year":"2024","journal-title":"Int J Dermatol"},{"issue":"5","key":"doi250040r18","doi-asserted-by":"publisher","first-page":"1357","DOI":"10.1016\/j.jaad.2020.10.083","article-title":"Analysis of hidradenitis suppurativa hospitalizations: a report from the National Inpatient Sample database.","volume":"85","author":"Edigin","year":"2021","journal-title":"J Am Acad Dermatol"},{"issue":"8","key":"doi250040r19","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.31168","article-title":"Estimating sepsis incidence using administrative data and clinical medical record review.","volume":"6","author":"Mellhammar","year":"2023","journal-title":"JAMA Netw Open"},{"issue":"6","key":"doi250040r20","doi-asserted-by":"publisher","first-page":"1291","DOI":"10.1016\/j.jaad.2024.02.022","article-title":"Sepsis-like features in hidradenitis suppurativa flares requiring admission: a retrospective cohort study.","volume":"90","author":"AbdelHameid","year":"2024","journal-title":"J Am Acad Dermatol"},{"issue":"3","key":"doi250040r21","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1093\/bjd\/ljae095","article-title":"Hidradenitis suppurativa (HS), systemic inflammatory response syndrome and sepsis, sepsis caused by HS: an empty systematic review.","volume":"191","author":"Maghari","year":"2024","journal-title":"Br J Dermatol"},{"issue":"3","key":"doi250040r22","doi-asserted-by":"publisher","DOI":"10.1016\/j.xjidi.2025.100349","article-title":"Noncutaneous infections in patients with hidradenitis suppurativa: a retrospective cohort study.","volume":"5","author":"Wafae","year":"2025","journal-title":"JID Innov"},{"issue":"12","key":"doi250040r23","doi-asserted-by":"publisher","first-page":"846","DOI":"10.7326\/0003-4819-157-12-201212180-00004","article-title":"Adalimumab for the treatment of moderate to severe Hidradenitis suppurativa: a parallel randomized trial.","volume":"157","author":"Kimball","year":"2012","journal-title":"Ann Intern Med"},{"issue":"4","key":"doi250040r24","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1016\/j.jaad.2006.05.027","article-title":"Clinical response to adalimumab treatment in patients with moderate to severe psoriasis: double-blind, randomized controlled trial and open-label extension study.","volume":"55","author":"Gordon","year":"2006","journal-title":"J Am Acad Dermatol"},{"issue":"4","key":"doi250040r25","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1016\/j.jnma.2024.07.038","article-title":"Antibiotic usage for hidradenitis suppurativa: risk for infection and death.","volume":"116","author":"Marc","year":"2024","journal-title":"J Natl Med Assoc"},{"key":"doi250040r26","doi-asserted-by":"publisher","DOI":"10.3399\/BJGPO.2020.0181","article-title":"Is there an association between long-term antibiotics for acne and subsequent infection sequelae and antimicrobial resistance? a systematic review.","author":"Bhate","journal-title":"BJGP Open"},{"issue":"1","key":"doi250040r27","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1111\/bjd.17101","article-title":"Impact of hidradenitis suppurativa on work loss, indirect costs and income.","volume":"181","author":"Tzellos","year":"2019","journal-title":"Br J Dermatol"},{"issue":"9","key":"doi250040r28","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-030579","article-title":"Disease burden and cost of hidradenitis suppurativa: a retrospective examination of US administrative claims data.","volume":"9","author":"Marvel","year":"2019","journal-title":"BMJ Open"},{"key":"doi250040r3","unstructured":"Humira. Prescribing information. AbbVie; 2002. Accessed March 17, 2024. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2018\/125057s406lbl.pdf"}],"container-title":["JAMA Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamadermatology\/articlepdf\/2837975\/jamadermatology_wafae_2025_oi_250040_1762976603.56075.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T16:00:40Z","timestamp":1763568040000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamadermatology\/fullarticle\/2837975"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,1]]},"references-count":28,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamadermatol.2025.2881","relation":{},"ISSN":["2168-6068"],"issn-type":[{"type":"print","value":"2168-6068"}],"subject":[],"published":{"date-parts":[[2025,11,1]]}}}