Efficacy Gaps Remain Despite Therapeutic Advances in HS

Hidradenitis suppurativa (HS) remains a chronic, debilitating inflammatory condition characterized by recurrent, painful nodules and abscesses, often leading to scarring and significant quality-of-life impairment. In a recent discussion with Dermatology Times, Alexa Kimball, MD, MPH, president and CEO of Harvard Medical Faculty Physicians and professor of dermatology at Harvard Medical School, outlined the current landscape of HS management and highlighted ongoing clinical challenges and opportunities.

Over the past 10 to 15 years, substantial progress has been made in the treatment of HS, with 3 medications now approved for use. Despite these advancements, Kimball emphasized that many patients continue to require more aggressive or advanced therapeutic strategies. Elevating clinical efficacy remains a key priority, as a significant proportion of individuals with HS still experience persistent symptoms and disease burden despite available therapies.

Beyond treatment response, Kimball noted the importance of addressing HS as a lifelong condition. Patients often face decades of disease activity, accompanied by both physical disability and comorbid conditions. These realities underscore the need for long-term management strategies that extend beyond symptom control. However, the design of robust studies capable of capturing comorbidity patterns and long-term outcomes presents challenges, particularly due to the large sample sizes required.

Another consideration raised in the interview was patient-centered care. Kimball highlighted the necessity of incorporating quality-of-life measures and functional outcomes into clinical research and practice. HS is associated with high psychosocial burden, and integrating these dimensions into treatment goals may help optimize care for affected individuals.

Looking forward, the dermatology community faces the dual imperative of expanding the therapeutic armamentarium while refining approaches to holistic patient management. Novel therapeutic pathways, real-world evidence, and multidisciplinary strategies will likely play central roles in the next phase of HS care.

Kimball concluded that while the field has seen impressive progress, there remains significant unmet need. Improving treatment efficacy, addressing comorbidities, and prioritizing patient well-being are central to advancing HS management and improving outcomes for this complex, chronic condition.