Posted on Friday - 08/26/2022 to Up Close
By Barbara Anderson
UCSF Fresno is preparing to enroll participants in a worldwide study to evaluate a potential new treatment for hidradenitis suppurativa (HS), a chronic, inflammatory skin disease that is very painful and has no cure.
HS can be devastating and debilitating. Boil-like abscesses develop in areas where skin rubs together, such as under armpits, on inner thighs, the groin, buttocks and under breasts. Some cases are mild, but in severe cases, lesions can rupture and drain pus with an odor. The abscesses can leave scars.
The condition, which is not contagious, tends to first manifest in teenagers and young adults. There is no known cause, but a genetic predisposition is suspected, and cigarette smoking and excess weight are possible factors. The condition can last for years and worsen over time and lead to complications, including impairing mobility. “We’ll see people in wheelchairs because they cannot walk or move,” said Gregory Simpson, MD, a UCSF Fresno dermatologist and UCSF professor.
Presently, treatment for HS varies – from topical medications, antibiotics, to cortosteroid injections, laser treatments and surgery – based on the severity of the condition. Anti-tumor necrosis factor (TNF) therapy has offered some clinical benefit but has not been helpful to all HS patients.
“We have been attacking HS in so many different ways, and nothing really works that well so far,” said Dr. Simpson. He and colleague Luis Dehesa, UCSF Fresno dermatologist and UCSF associate clinical professor, are co-principal investigators at the UCSF Fresno site of a phase 2, multi-center, randomized, double-blind controlled study to evaluate the safety of lutikizumab, an interleukin-1 blocker, in adults with moderate to severe HS who have failed anti-tumor necrosis factor (Anti-TNF) therapy.
“HS looks like an acne-based problem, but it is really an inflammatory problem and this medication (lutikizumab) blocks one of the inflammatory pathways,” Dr. Simpson said. “We are hopeful it will prevent big abscesses from forming in the first place.”
UCSF Fresno is among 50 sites worldwide for the study to compare lutikizumab to a placebo. Participants will receive a subcutaneous injection of lutikizumab or a placebo every week for 16 weeks. The study is sponsored by AbbVie, a research-based global pharmaceutical company.
Research is an integral part of UCSF Fresno’s mission to improve health in the San Joaquin Valley. The HS clinical trial is one of the latest for the Division of Dermatology in the UCSF Fresno Department of Internal Medicine. Drs. Dehesa and Simpson have participated in clinical trials of medications for atopic dermatitis that have led to new medications being approved for use in recent years by the FDA, for example.
Drs. Dehesa and Simpson are hopeful the HS clinical trial will similarly result in an effective therapy for HS patients. “HS affects quality of life and we don’t have a good medication to control it,” Dr. Dehesa said. “We are looking for a better alternative and hopefully we will find something that really works. These are patients who need more help.”
Patients are being enrolled at University Dermatology Associates in Fresno.