Recognizing
HS
For the treatment of moderate to severe hidradenitis
suppurativa (HS) in patients 12 years of age and older
Not an actual HS patient
Looking to
treat with
HUMIRA?
Hidradenitis suppurativa (HS) is a chronic, immune-mediated skin disease that can be progressive and debilitating.2,3
It occurs in many patients’ most sensitive areas.4 Due to the progressive nature of HS, an early, accurate diagnosis is critical before symptoms become more severe.5
Prompt identification and diagnosis is one of the most unmet needs in managing HS3
is the average delay in seeing
a physician (from symptom
onset to first visit)6
is the average delay
in diagnosing HS7
are typically seen before an HS
diagnosis is made6-8
When identifying HS, it is important to know who is typically affected and the challenges that may delay diagnosis. Women are more likely than men to develop HS, with a 3:1 ratio. Symptoms occur in patients' most sensitive areas and can start at any time between puberty and middle age—with the average age of onset around 21.4,9,10
There are 2 key reasons timely HS diagnosis can be challenging. First, patients may be embarrassed and wait until symptoms become severe before seeking medical attention. Secondly, early HS lesions may be mistaken for infections, STDs, or other skin conditions.11,12
Three criteria must be present to consider a diagnosis of HS13:
Typical signs and symptoms of moderate to severe HS include4,13:
Inflamed, painful lesions and nodules
Abscesses
Sinus tracts*
(non-draining or draining with malodorous discharge)
Double comedones
Bridged, hypertrophic scarring
Consider asking your patient: Have you experienced tender, raised bumps or boils?
*Photo courtesy of Dr. Marc Bourcier.
HS lesions typically appear in 1 or more of the following anatomical locations: axilla, groin, genitals, buttocks, or under the breasts. However, lesions can occur anywhere on the body.11,13,14
Consider asking your patient:
Have these bumps or boils appeared on your inner thighs or groin, under your arms or breasts, or on your buttocks?
Patients with HS often present with a history of chronic inflammation and recurrence of lesions in the same or different anatomical locations. Many HS patients will experience 2 or more recurrences over a 6-month period.13,15
Consider asking your patient:
Have these symptoms reappeared 2 or more times in the past 6 months in the same or different location?
Other Considerations
To help with diagnosing HS, also consider asking your patients13:
Have any scars formed where you experienced these bumps?
Do you have a family history of similar symptoms and/or HS?
The severity of HS may be determined by the Hurley staging system, a widely used classification.4,9
Typically presents as abscess formation, single or multiple, without sinus tracts and scarring
Reprinted with permission from Jemec, 2012.9
Typically presents as recurrent abscesses with sinus tract formation and scarring; single or multiple widely separated lesions
Typically presents as diffuse or near-diffuse involvement with multiple interconnected sinus tracts and abscesses across entire area
Photo courtesy of Dr. Marc Bourcier.
The Progressive Nature of HS
As HS goes undiagnosed, the disease can progress to more severe symptoms, such as the development of sinus tracts and scarring, that may leave irreversible, disabling damage.11
Often devastating for patients, frustrating for physicians
Partner with a dermatologist experienced in HS to confirm the diagnosis as soon as you suspect HS.
– Insight from actual HS patient
Plaque Psoriasis: HUMIRA is indicated for the treatment of adult patients with moderate to severe chronic plaque psoriasis who are candidates for systemic therapy or phototherapy, and when other systemic therapies are medically less appropriate. HUMIRA should only be administered to patients who will be closely monitored and have regular follow-up visits with a physician.
Psoriatic Arthritis: HUMIRA is indicated, alone or in combination with non-biologic DMARDs, for reducing signs and symptoms, inhibiting the progression of structural damage, and improving physical function in adult patients with active psoriatic arthritis.
Hidradenitis Suppurativa: HUMIRA is indicated for the treatment of moderate to severe hidradenitis suppurativa in patients 12 years of age and older.
Patients treated with HUMIRA are at increased risk for developing serious infections that may lead to hospitalization or death. Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids.
Discontinue HUMIRA if a patient develops a serious infection or sepsis.
Reported infections include:
Carefully consider the risks and benefits of treatment with HUMIRA prior to initiating therapy in patients: 1. with chronic or recurrent infection, 2. who have been exposed to TB, 3. with a history of opportunistic infection, 4. who resided in or traveled in regions where mycoses are endemic, 5. with underlying conditions that may predispose them to infection. Monitor patients closely for the development of signs and symptoms of infection during and after treatment with HUMIRA, including the possible development of TB in patients who tested negative for latent TB infection prior to initiating therapy.
Lymphoma and other malignancies, some fatal, have been reported in children and adolescent patients treated with TNF blockers, including HUMIRA. Postmarketing cases of hepatosplenic T-cell lymphoma (HSTCL), a rare type of T-cell lymphoma, have been reported in patients treated with TNF blockers, including HUMIRA. These cases have had a very aggressive disease course and have been fatal. The majority of reported TNF blocker cases have occurred in patients with Crohn’s disease or ulcerative colitis and the majority were in adolescent and young adult males. Almost all of these patients had received treatment with azathioprine or 6-mercaptopurine concomitantly with a TNF blocker at or prior to diagnosis. It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants.
Rheumatoid Arthritis: HUMIRA is indicated, alone or in combination with methotrexate or other non-biologic DMARDs, for reducing signs and symptoms, inducing major clinical response, inhibiting the progression of structural damage, and improving physical function in adult patients with moderately to severely active rheumatoid arthritis.
Juvenile Idiopathic Arthritis: HUMIRA is indicated, alone or in combination with methotrexate, for reducing signs and symptoms of moderately to severely active polyarticular juvenile idiopathic arthritis in patients 2 years of age and older.
Psoriatic Arthritis: HUMIRA is indicated, alone or in combination with non-biologic DMARDs, for reducing signs and symptoms, inhibiting the progression of structural damage, and improving physical function in adult patients with active psoriatic arthritis.
Ankylosing Spondylitis: HUMIRA is indicated for reducing signs and symptoms in adult patients with active ankylosing spondylitis.
Adult Crohn’s Disease: HUMIRA is indicated for reducing signs and symptoms and inducing and maintaining clinical remission in adult patients with moderately to severely active Crohn’s disease who have had an inadequate response to conventional therapy, and reducing signs and symptoms and inducing clinical remission in these patients if they have also lost response to or are intolerant to infliximab.
Pediatric Crohn’s Disease: HUMIRA is indicated for reducing signs and symptoms and inducing and maintaining clinical remission in pediatric patients 6 years of age and older with moderately to severely active Crohn’s disease who have had an inadequate response to corticosteroids or immunomodulators such as azathioprine, 6-mercaptopurine, or methotrexate.
Ulcerative Colitis: HUMIRA is indicated for inducing and sustaining clinical remission in adult patients with moderately to severely active ulcerative colitis who have had an inadequate response to immunosuppressants such as corticosteroids, azathioprine, or 6-mercaptopurine. The effectiveness of HUMIRA has not been established in patients who have lost response to or were intolerant to anti-TNF agents.
Plaque Psoriasis: HUMIRA is indicated for the treatment of adult patients with moderate to severe chronic plaque psoriasis who are candidates for systemic therapy or phototherapy, and when other systemic therapies are medically less appropriate. HUMIRA should only be administered to patients who will be closely monitored and have regular follow-up visits with a physician.
Hidradenitis Suppurativa: HUMIRA is indicated for the treatment of moderate to severe hidradenitis suppurativa in patients 12 years of age and older.
Uveitis: HUMIRA is indicated for the treatment of non-infectious intermediate, posterior, and panuveitis in adults and pediatric patients 2 years of age and older.
Please see Full Prescribing Information.
US-HUM-181930
References: 1. HUMIRA Injection [package insert]. North Chicago, IL: AbbVie Inc. 2. Nazary M, van der Zee HH, Prens EP, Folkerts G, Boer J. Pathogenesis and pharmacotherapy of hidradenitis suppurativa. Eur J Pharmacol. 2011;672(1-3):1-8. 3. Kerdel FA, Menter A, Micheletti RG. Introduction. Semin Cutan Med Surg. 2014;33(suppl 3):S47. 4. Alikhan A, Lynch PJ, Eisen DB. Hidradenitis suppurativa: a comprehensive review. J Am Acad Dermatol. 2009;60(4):539-561. 5. Woodruff CM, Charlie AM, Leslie KS. Hidradenitis suppurativa: a guide for the practicing physician. Mayo Clin Proc. 2015;90(12):1679-1693. 6. Saunte DM, Boer J, Stratigos A, et al. Diagnostic delay in hidradenitis suppurativa is a global problem. Br J Dermatol. 2015;173(6):1546-1549. 7. Garg A, Neuren E, Cha D, et al. Evaluating patients' unmet needs in hidradenitis suppurativa: results from the Global Survey Of Impact and Healthcare Needs (VOICE) Project. J Am Acad Dermatol. 2020;82(2):366-376. 8. Alavi A, Lynde C, Alhusayen R, et al. Approach to the management of patients with hidradenitis suppurativa: a consensus document. J Cutan Med Surg. 2017;21(6):513-524. 9. Jemec GBE Clinical practice. Hidradenitis suppurativa. N Engl J Med. 2012;366(2):158-164. 10. Collier F, Smith RC, Morton CA. Diagnosis and management of hidradenitis suppurativa. BMJ. 2013;346:f2121. 11. Micheletti RG. Natural history, presentation, and diagnosis of hidradenitis suppurativa. Semin Cutan Med Surg. 2014;33(suppl 3):S51-S53. 12. Kimball AB, Jemec GBE, eds. Hidradenitis Suppurativa: A Disease Primer. Switzerland: Springer International Publishing AG; 2017. 13. van der Zee HH, Jemec GBE. New insights into diagnosis of hidradenitis suppurativa: clinical presentations and phenotypes. J Am Acad Dermatol. 2015;73(5)(suppl 1):S23-S26. 14. Vazquez BG, Alikhan A, Weaver AL, Wetter DA, Davis MD. Incidence of hidradenitis suppurativa and associated factors: a population-based study of Olmsted County, Minnesota. J Invest Dermatol. 2013;133(1):97-103. 15. Vinding GR, Miller IM, Zarchi K, Ibler KS, Ellervik C, Jemec GBE. The prevalence of inverse recurrent suppuration: a population-based study of possible hidradenitis suppurativa. Br J Dermatol. 2014;170(4):884-889. 16. Kimball AB, Okun MM, Williams DA, et al. Two phase 3 trials of adalimumab for hidradenitis suppurativa. N Engl J Med. 2016;375(5):422-434. 17. Data on file, AbbVie Inc. ABVRRTI68916.