Obesity reduces adalimumab potency against hidradenitis suppurativa

Adalimumab for the treatment of hidradenitis suppurativa appears to be less effective in patients with obesity, a study has found.

Researchers reviewed the medical records of patients with hidradenitis suppurativa treated with adalimumab at Montefiore/Einstein HS Center in New York, US. They looked at disease severity (HS-Physician Global Assessment [HS-PGA] 0 and Numerical Rating Scale Pain [NRS-Pain]) and inflammatory markers (erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], and interleukin-6 [IL-6]) to examine the association between body mass index (BMI) and adalimumab efficacy. A BMI of ≥30 kg/m² was categorized as obese, while that of <30 kg/m² was categorized as nonobese.

The analysis included 57 patients (mean age 35.8 years). In the group of nonobese patients, adalimumab therapy led to significant reductions in HS-PGA (−1.5; p<0.0001) and NRS-Pain (−1.6; p<0.0001). In terms of inflammatory markers, treatment produced nonsignificant changes in ESR (−17.90), CRP (−0.71), and IL-6 (−5.88; p>0.05).

On the other hand, obese patients treated with adalimumab saw mean increases in HS-PGA (0.22; p>0.05) and NRS-Pain scores (1.41; p>0.05) as well as mean increases in ESR (2.62), CRP (0.44), and IL-6 (2.35; p>0.05).

The between-group differences in changes in HS-PGA, NRS-Pain, ESR, and IL-6 following adalimumab therapy were significantly different, in favour of the nonobese group (p<0.05).

The findings show that patients with BMI ≥30 kg/m² exhibited signs of both clinical and physiological deterioration while on adalimumab. More studies are needed to examine adalimumab dosing for hidradenitis suppurativa patients with high BMI, as well as to explore weight-based therapies.