Efficacy of Secukinumab in Chinese Patients with Moderate-to-Severe Hidradenitis Suppurativa: A 16-Week, Single-Center, Prospective, Real-World Study.

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease in which interleukin-17A (IL-17A) is an important therapeutic target. However, prospective real-world data on secukinumab (IL-17A inhibitor) safety and efficacy in Chinese patients with HS remain limited. Objective: To evaluate the 16-week efficacy and safety of secukinumab in Chinese patients with moderate-to-severe HS and explore potential treatment response predictors. Methods: This single-center, prospective, real-world cohort study included 31 patients with moderate-to-severe HS. The patients received subcutaneous secukinumab 300 mg weekly for 5 weeks, followed by administration either every 2 (1 patient [3.23%]) or 4 (30 patients [96.77%]) weeks. Concomitant therapies were allowed when clinically indicated. The primary endpoint was Hidradenitis Suppurativa Clinical Response (HiSCR) at week 16. Secondary endpoints included changes in inflammatory nodule, abscess, and draining tunnel counts, International Hidradenitis Suppurativa Severity Score System (IHS4), Numeric Rating Scale (NRS) for pain, Dermatology Life Quality Index (DLQI), adverse events, and exploratory predictors of HiSCR. Results: The cohort was predominantly male (77.42%). Ten patients (32.26%) were classified as Hurley stage II and 21 (67.74%) as Hurley stage III. During treatment, 74.19% of patients received concomitant therapies. At week 16, HiSCR was achieved by 17/31 patients (54.84%). Inflammatory nodule counts, draining tunnel counts, IHS4, and DLQI significantly decreased. In the adjusted multivariate logistic regression model, after adjustment for prior biologic use, decreased high-density lipoprotein cholesterol, and dyslipidemia, elevated triglyceride was independently associated with HiSCR achievement (β= 3.246, p = 0.037). Adverse events were mild, including acne in two patients (6.45%), facial allergic dermatitis in one (3.23%), fever in two (6.45%), and fatigue in one (3.23%). None discontinued treatment because of adverse events. Conclusions: Secukinumab demonstrated meaningful 16-week efficacy and favorable safety in Chinese patients with moderate-to-severe HS. Elevated triglyceride was associated with treatment response in this exploratory analysis; however, further validation in larger cohorts is required.