Clinical Implications for High-Level Treatment Responses in HS

Dr. Martina Porter explains that dose–response is harder to detect at the 50% improvement level but becomes more apparent when looking at higher bars of clearance. For HiSCR75 in STOP HS 1, placebo achieved about 15%, versus 20% with 45 mg povorcitinib and ~25% with 75 mg; this numerical dose trend, however, was not statistically significant. In STOP HS 2, where the placebo rate was lower (13%), the separation became statistically significant, with 25.5% reaching HiSCR75 on 45 mg and 28.4% on 75 mg, again suggesting a modest but real dose effect when responses are deeper.

They note that baseline differences between STOP HS 1 and 2 (e.g., slightly greater severity in STOP HS 1) likely influence these results and will be better understood in future subgroup and post‑hoc analyses. The discussion then reframes HiSCR90 and HiSCR100: while only about 8–15% and ~10% of patients, respectively, reach these levels at 12 weeks, placebo rates are well under 10%, meaning these are true treatment effects. Achieving HiSCR100—no inflammatory lesions—is transformational for patients, allowing many to live as if they don’t have HS. Finally, Dr. Hadar Lev‑Tov points out that the 75 mg dose roughly doubles the proportion reaching HiSCR90/100 versus placebo in 12 weeks, which supports the clinical rationale for having multiple oral doses available, even though dose optimization and “mix and match” strategies would be off‑label and must stay within safety limits.

In the next episode, panelists will continue their discussion on HS and highlight its quality of life impact.