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While surgical excision is a mainstay of therapy, lesions often recur. Biologic therapies, including tumor necrosis factor\u2010<jats:italic>\u03b1<\/jats:italic> and <jats:styled-content style=\"fixed-case\">IL<\/jats:styled-content>\u201012\/23 inhibitors, are effective for mild to moderate <jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content>. However, longitudinal studies investigating biologic therapy in conjunction with surgery are limited. The purpose of this analysis was to investigate impact of surgery and biologic therapy on <jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content> disease activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from 68 <jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content> patients were analyzed. Outcome measures included hidradenitis suppurativa Sartorius Score (<jats:styled-content style=\"fixed-case\">HSS<\/jats:styled-content>), active nodule (<jats:styled-content style=\"fixed-case\">AN<\/jats:styled-content>) count, Hurley stage, and probability of achieving 75% reduction in active nodule count (<jats:styled-content style=\"fixed-case\">AN<\/jats:styled-content>75).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean age was 40\u00a0\u00b1\u00a014\u00a0years; 66% were female and 72% were African American. Mean disease duration was 10\u00a0years, and Hurley stage <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> disease was seen in 63% of patients. Patients who received biologics had a larger drop in <jats:styled-content style=\"fixed-case\">HSS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">AN<\/jats:styled-content> count than those who never received biologics (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.002). Biologic treatment was associated with average reduction in 22 (15\u201329) <jats:styled-content style=\"fixed-case\">HSS<\/jats:styled-content> points (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001). The effect of biologics was greater in patients who also underwent surgery (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.013). Timing of biologics relative to surgery did not impact efficacy. Patients who received <jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content> surgery with biologic therapy were most likely to achieve the <jats:styled-content style=\"fixed-case\">AN<\/jats:styled-content>75 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.017).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this diverse cohort of patients with severe <jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content>, biologic therapy was associated with a more rapid decline in disease activity, with the greatest effect in patients who also underwent <jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content> surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.13798","type":"journal-article","created":{"date-parts":[[2017,11,11]],"date-time":"2017-11-11T13:02:47Z","timestamp":1510405367000},"page":"62-69","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["Longitudinal observational study of hidradenitis suppurativa: impact of surgical intervention with adjunctive biologic therapy"],"prefix":"10.1111","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5882-4884","authenticated-orcid":false,"given":"Victoria K.","family":"Shanmugam","sequence":"first","affiliation":[{"name":"Division of Rheumatology Ideas to Health Laboratory School of Medicine and Health Sciences The George Washington University Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaunak","family":"Mulani","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Ideas to Health Laboratory School 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