{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T09:36:37Z","timestamp":1771493797449,"version":"3.50.1"},"reference-count":43,"publisher":"Scientific Scholar","content-domain":{"domain":["ijdvl.com"],"crossmark-restriction":true},"short-container-title":["IJDVL"],"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Hidradenitis suppurativa (HS) is a challenging inflammatory skin condition. Recently, many different biologics have been tested for HS, but the paucity of head-to-head comparative trials makes it difficult to determine the real value of each biological intervention. We aimed to determine the relative efficacy among biologics in treating moderate-to-severe HS throughout a network meta-analysis (NMA) and, to identify which pathogenetic pathways may be the most appropriate to target.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We comprehensively identified studies in 3 databases and clinicaltrials.gov. The eligibility criteria included randomised controlled trials (RCTs) reporting data on the efficacy of moderate-to-severe HS.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The NMA comprised 13 studies comprising 14 interventions on 2,748 participants in the network. The NMA showed the odds of achieving the clinical response were significantly superior with adalimumab (RR: 0.37, 95% CI = 0.06\u20130.63), adalimumab QW (RR: 0.63, 95% CI = 0.43\u20130.87), MAB1p (RR: 1.33, 95% CI = 0.03\u20133.12), secukinumab (RR: 0.25, 95% CI = 0.11\u20130.47) and secukinumabQ2W (RR: 0.24, 95% CI = 0.1\u20130.46) compared to placebo.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Based on the NMA, inhibiting tumour necrosis factor (TNF)-a with adalimumab appears to be the best strategy, followed by the blockade of IL--17 with secukinumab. Data for bimekizumab and CJM112 are promising. Infliximab has inconsistent clinical response, and more data are necessary to confirm this molecule as a potential third-line therapy in HS. The blockade of IL-23 and CD5a pathways is not relevant, or at least the current evidence is insufficient to recommend further investigation of guselkumab, risankizumab, and vilobelimab in phase III trials.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/ijdvl_665_2023","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T12:20:41Z","timestamp":1709122841000},"page":"302-310","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparative efficacy and therapeutic positioning of biologics in hidradenitis suppurativa: A systematic review with network meta-analysis of randomised trials"],"prefix":"10.25259","volume":"90","author":[{"given":"Husein","family":"Husein-ElAhmed","sequence":"first","affiliation":[{"name":"Department of Dermatology, Hospital de Baza, Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Husein-ElAhmed","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Montefr\u00edo Health Center, Andalusian Health Service, C. Mariana Pineda, Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2024,2,28]]},"reference":[{"key":"10.25259\/IJDVL_665_2023\/ref-1","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1159\/000431175","article-title":"Hidradenitis Suppurativa\/acne inversa: Criteria for diagnosis, severity assessment, classification and disease evaluation","volume":"231","author":"Zouboulis","year":"2015","journal-title":"Dermatology (Basel, Switzerland)"},{"key":"10.25259\/IJDVL_665_2023\/ref-2","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1159\/000453355","article-title":"Quality of life and psychosocial implications in patients with hidradenitis suppurativa","volume":"232","author":"Kouris","year":"2016","journal-title":"Dermatology (Basel, Switzerland)"},{"key":"10.25259\/IJDVL_665_2023\/ref-3","doi-asserted-by":"publisher","first-page":"2965","DOI":"10.3389\/fimmu.2018.02965","article-title":"Hidradenitis suppurativa: A systematic review integrating inflammatory pathways into a cohesive pathogenic model","volume":"9","author":"Vossen","year":"2018","journal-title":"Front. 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