The Path to Long-Term Control: Thrasyvoulos Tzellos, MD, PhD, Discusses the Burden of HS

In an exclusive interview with Dermatology Times, Thrasyvoulos Tzellos, MD, PhD, a dermatologist based in Norway, provided a comprehensive clinical perspective on the day-to-day burden and long-term consequences of hidradenitis suppurativa (HS), drawing on his research experience and daily patient care.

Tzellos emphasized that HS is distinct from other chronic inflammatory skin diseases because of its progressive nature. The condition often begins with inflammatory nodules and abscesses but can evolve into a more destructive stage characterized by draining and nondraining tunnels, extensive scarring, and fibrosis. Once these structural changes develop, the disease becomes significantly more difficult to treat and substantially more debilitating for patients. He underscores that draining tunnels, in particular, are strongly associated with persistent daily pain, malodor, continuous suppuration, and profound impairment in quality of life.

The cumulative burden of HS extends far beyond physical symptoms. Patients frequently report the need for constant clothing changes due to drainage, reduced sexual activity, and social withdrawal. Importantly, HS often affects young individuals during critical periods of personal and professional development, interfering with work productivity, daily activities, and psychological well-being. According to Tzellos, the combination of chronic pain, functional limitations, and disease progression contributes to a cycle of worsening disease severity and diminished quality of life once fibrosis and tunnels are established.

Addressing the unmet need is UCB’s BE HEARD clinical program for bimekizumab. Earlier this month, the company shared positive long-term data at the 15th Conference of the European Hidradenitis Suppurativa Foundation in San Giljan, Malta. Tzellos highlighted that, over 3 years of follow-up, treatment was associated with meaningful and durable reductions in draining tunnels—an outcome of particular clinical relevance given their central role in pain and disability. Notably, these improvements were not transient; reductions in tunnels were sustained over time.

Equally important, a substantial proportion of patients transitioned from moderate or severe disease to mild or inactive status. Mild disease was described as having minimal or no draining tunnels, whereas inactive disease was characterized by the absence of inflammatory lesions altogether. Tzellos interprets these findings as promising evidence that long-term bimekizumab therapy may not only control inflammation but also prevent further disease progression and, to some extent, reverse established damage.