Fostamatinib safe, effective in moderate-to-severe hidradenitis suppurativa

Treatment with fostamatinib, a spleen tyrosine kinase inhibitor that targets B cells and plasma cells, is well tolerated by patients with hidradenitis suppurativa (HS), resulting in improved clinical outcomes with no serious adverse events, a study has shown.

“Targeting B cells [and] plasma cells may be a viable therapeutic strategy in HS and requires further exploration,” the authors said.

Twenty patients with moderate-to-severe HS received fostamatinib 100 mg twice a day for 4 weeks, which was escalated to 150 mg twice a day until week 12, in this study.

The authors evaluated the patients for adverse events and clinical response, assessed using the Hidradenitis Suppurativa Clinical Response Score (HiSCR) and the International Hidradenitis Suppurativa Severity Score (IHS4). They also assessed other outcomes, including the Dermatology Life Quality Index (DLQI), visual analogue scale, and physician global assessment.

All participants completed the week 4 and week 12 endpoints. Use of fostamatinib was tolerable among these patients, and no grade 2/3 adverse events occurred.

Of the participants, 85 percent achieved HiSCR at week 4 and 85 percent at week 12. Disease activity decreased the most during weeks 4 and 5, with worsening in the proportion of patients afterwards. In addition, treatment with fostamatinib eased both pain and itch and resulted in a significantly improved quality of life.

“HS is an autoinflammatory disorder of keratinization with a prominence of B cells and plasma cells,” the authors said.