Adalimumab na hidradenite supurativa- avaliação da resposta clinica e do impacto nos marcadores inflamatório

Abstract

Background: Hidradenitis suppurativa (HS) is a recurrent chronic inflammatory disease marked by painful lesions in intertriginous regions. Recent studies highlight neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR) and C-reactive protein (CRP) as systemic inflammation markers correlated with disease severity. Objectives: This study aims to analyse changes in inflammatory parameters in HS patients pre and post 16-week adalimumab treatment. We seek to understand if the changes in these parameters have any correlation with the response to treatment. Methods: A retrospective cohort of 44 adalimumab-treated HS patients was used to evaluate laboratory (NLR, PLR, MLR, CRP) and clinical parameters (DLQI, IHS4, IHS4-55 and PI-NRS). Data, collected between 2019 and 2023, underwent statistical analysis including t-tests, Wilcoxon signed-rank tests and Pearson correlation tests, comparing pre- and post-treatment values. Results: Adalimumab treatment led to a significant improvement in HS inflammatory markers. Clinical scores, including DLQI, (p < 0.0001), IHS4 (P < 0.0001) and PI - NRS (p < 0.0001) had a significant reduction pos treatment. Analytical variables, NLR (p = 0.02), PLR (p = 0.02), CRP median (p = 0.01), MLR median (p = 0.027) also exhibited significant decreases. IHS4-55 scores didn't demonstrate a 55% reduction in most patients. No significant correlation was found between baseline clinical scores and inflammatory parameters. Conclusions: All systemic inflammation-based biomarkers were significantly reduced after starting adalimumab. The clinical scores of DLQI, IHS4 and PI - NRS also portrayed a significant reduction. Contrarily IHS4-55 score didn't demonstrate a 55% reduction in most patients. This suggests that hematological markers of inflammation may predict the response to treatment with adalimumab.