Quality of Life Impact and Value of Patient-Reported Outcomes in HS

Dr. Martina Porter explains that pain was measured using daily 0–10 numeric rating scales, then grouped as no/mild, moderate, or severe pain to better reflect HS reality, where scars and chronically altered skin can remain painful even when not visibly inflamed.

At baseline, only about 36% of patients reported no or mild pain; more than half had moderate pain, and over 10% had severe pain (≥8/10). By week 12, the proportion with no/mild pain rose to 57%, and by week 24 to 62%, while moderate pain dropped from 53% to about 30%. On the 75 mg dose, improvements were even more striking: no/mild pain rose from 35% at baseline to 57% at week 12 and 70% at week 24. Dr. Porter notes that HiSCR is lesion-count–based and can miss clinically meaningful shifts—such as a large abscess shrinking substantially (with major pain relief) but still being counted as a lesion.

Dr. Hadar Lev‑Tov highlights how rapid, tangible pain relief builds trust and engagement, especially in HS patients who have often been dismissed or stigmatized. The discussion then turns to draining tunnels (sinus tracts). Among patients with tunnels at baseline, roughly one-third on 45 mg and 41% on 75 mg had DT100 (no draining tunnels) by week 12; by week 24, that rose to 39% on 45 mg and 50% on 75 mg. Because tunnels drive much of HS morbidity, the panel sees this as a particularly compelling signal, potentially related to JAK1’s role in fistulizing disease, and a future guide to treatment selection by lesion phenotype.

The next episode in this series features the panelists advancing their conversation on HS and focusing on the safety considerations for povorcitinib in HS.