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Introduction <p>Hidradenitis suppurativa (HS), a chronic, inflammatory skin disease, causes significant morbidity. Until 2023, adalimumab was the only US-approved biologic for patients with moderate&#xa0;to&#xa0;severe HS.</p> Aim <p>This study describes the clinical profile, treatment utilization, and residual disease burden in patients with HS initiating adalimumab in the USA.</p> Methods <p>This observational cohort study used data from the Merative MarketScan<sup>®</sup> Commercial, Medicare, and Multi-State Medicaid claims databases. Adult patients who initiated adalimumab treatment between 2015 and 2018 were included (main cohort). Patients required continuous insurance enrolment during the year prior to adalimumab initiation (baseline period). Patients were followed until adalimumab discontinuation or study end (2022) to examine treatment patterns, discontinuation rates, predictors of discontinuation, and healthcare resource utilization (HCRU). Study objectives were repeated from the onset of the coronavirus 2019 (COVID-19) pandemic (COVID-19 cohort; 2020–2022). Statistical methods included Kaplan–Meier estimates and a multivariable proportional hazard regression model.</p> Results <p>The main cohort included 2367 adult patients (70.4% Commercial/Medicare-insured and 29.6% Medicaid-insured). Overall, 60.3% of patients discontinued adalimumab and 6.5% of patients switched from adalimumab to other biologics; the drug survival at 6 and 12 months was 68.4% and 48.0%, respectively. Discontinuation predictors (based on baseline characteristics) included female sex, younger age, Medicaid insurance, and undergoing excision surgery. Despite a decrease in HCRU events during adalimumab treatment, the need for interventions such as antibiotics and surgeries persisted. The COVID-19 cohort showed similar trends in adalimumab drug survival and HCRU.</p> Conclusion <p>While adalimumab improved certain outcomes in HS, residual burden and high discontinuation rates indicate the need for accessible and durable therapies.</p> Graphical Abstract <p></p>

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Residual Burden in Adalimumab-Treated Patients with Hidradenitis Suppurativa: An Observational Cohort Study Based on Insurance Claims in the USA

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月29日

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  • Maria A. Aleshin,
  • Tanja Tran,
  • Ingrid Pansar,
  • Aijing Shang,
  • David Friesen,
  • Alexa B. Kimball

摘要

Introduction

Hidradenitis suppurativa (HS), a chronic, inflammatory skin disease, causes significant morbidity. Until 2023, adalimumab was the only US-approved biologic for patients with moderate to severe HS.

Aim

This study describes the clinical profile, treatment utilization, and residual disease burden in patients with HS initiating adalimumab in the USA.

Methods

This observational cohort study used data from the Merative MarketScan® Commercial, Medicare, and Multi-State Medicaid claims databases. Adult patients who initiated adalimumab treatment between 2015 and 2018 were included (main cohort). Patients required continuous insurance enrolment during the year prior to adalimumab initiation (baseline period). Patients were followed until adalimumab discontinuation or study end (2022) to examine treatment patterns, discontinuation rates, predictors of discontinuation, and healthcare resource utilization (HCRU). Study objectives were repeated from the onset of the coronavirus 2019 (COVID-19) pandemic (COVID-19 cohort; 2020–2022). Statistical methods included Kaplan–Meier estimates and a multivariable proportional hazard regression model.

Results

The main cohort included 2367 adult patients (70.4% Commercial/Medicare-insured and 29.6% Medicaid-insured). Overall, 60.3% of patients discontinued adalimumab and 6.5% of patients switched from adalimumab to other biologics; the drug survival at 6 and 12 months was 68.4% and 48.0%, respectively. Discontinuation predictors (based on baseline characteristics) included female sex, younger age, Medicaid insurance, and undergoing excision surgery. Despite a decrease in HCRU events during adalimumab treatment, the need for interventions such as antibiotics and surgeries persisted. The COVID-19 cohort showed similar trends in adalimumab drug survival and HCRU.

Conclusion

While adalimumab improved certain outcomes in HS, residual burden and high discontinuation rates indicate the need for accessible and durable therapies.

Graphical Abstract