The Future of HS Treatment: Emerging Therapies on the Horizon

In "The Future of HS Treatment: Emerging Therapies on the Horizon," the panel looks five to fifteen years ahead at the therapies now advancing through development.

Asked which upcoming therapy excites them most, one panelist points to an oral JAK inhibitor, already approved for chronic spontaneous urticaria and expected in HS within a few years, as the first oral option and a mechanism entirely distinct from TNF or IL-17 pathways. He notes a B-cell-targeting therapy also in development represents yet another new mechanism, moving the field closer to precision medicine that could eventually treat comorbid inflammatory bowel disease without the contraindications current options carry.

Dr. Payette highlights what would be the first approved JAK inhibitor specifically for HS, citing promising week-16 and week-52 trial data across two doses, and notes patient preference often favors oral therapy over topical treatment, a dynamic he says will matter commercially. He adds that GLP-1 receptor agonists deserve recognition as standard of care already, not simply for weight loss but because adipocytes are metabolically active, inflammatory cells that store TNF and IL-17; reducing that reservoir can make patients more responsive to other therapies, a rationale reinforced by data showing roughly half of HS patients have metabolic syndrome.

Dr. Cices describes off-label use of a BTK inhibitor for patients with both HS and inflammatory bowel disease, alongside anticipated bispecific therapies targeting inflammatory bowel disease and HS together, and named new mechanisms including IL-1 and OX40 inhibition entering the pipeline. Panelists expect continued growth in GLP-1 use, both as monotherapy and combined with biologics, alongside advanced topical JAK and PDE4 inhibitors already used off-label to blunt individual flares. One panelist adds a practical detail: gastroenterology colleagues comfortably prescribe a higher induction dose of a shared biologic for inflammatory bowel disease than dermatologists typically use, a difference she says may explain some of the better responses seen in patients managed jointly with GI.

In the final episode of this series, "Panelists Share Their Go-To Regimens for Treating HS," the panel shares the go-to regimens they reach for across their most challenging HS patients.