Antiandrogen therapy with spironolactone for the treatment of hidradenitis suppurativa - 13/12/18
Abstract |
Background |
Hormonal therapy is a potential treatment for hidradenitis suppurativa (HS). However, few data exist describing the efficacy of spironolactone in treatment of HS.
Objective |
To assess whether spironolactone treatment improves HS disease severity and patient-reported pain.
Methods |
We performed a single-center chart review of female patients with HS who were treated with spironolactone between 2000 and 2017. Primary outcome measurements included the HS Physician's Global Assessment (HS-PGA), Hurley staging, inflammatory lesion count, fistula count, and a numeric rating scale for pain.
Results |
On average, subjects were exposed to 75 mg of spironolactone daily over a 7.1-month follow-up period. Patients achieved significant disease improvement with regard to pain (Δ-1.5 [P = .01]), inflammatory lesions (Δ-1.3 [P = .02]), and HS-PGA score (Δ-0.6 [P < .001]). As expected, no change was found for Hurley stage (Δ0 [P = .32]) or fistulas (Δ0 [P = .73]). There was no difference in improvement between subjects who received less than 75 mg of spironolactone daily (n = 25; average dose, 45 mg/d) and those who received more than 100 mg daily (n = 21; average dose, 112 mg/d).
Limitations |
Retrospective nature, limited sample size, and variations in severity measures documented were limiting factors.
Conclusions |
Management of HS with spironolactone reduces lesion count, HS-PGA score, and pain. Lower doses appear to be effective and may be an appropriate option for patients with tolerability concerns.
Le texte complet de cet article est disponible en PDF.Key words : antiandrogen, hidradenitis suppurativa, hormonal therapy, spironolactone
Abbreviations used : HS, HS-PGA, SD
Plan
| Funding sources: None. |
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| Disclosure: Dr Porter has received fellowship funding from Abbvie and Janssen. Dr Kimball serves as a consultant and investigator to Novartis, Abbvie, and UCB. Ms Golbari has no conflicts of interests to disclose. |
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| Ms Golbari and Dr Porter had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis, as well as for drafting of the manuscript and for statistical analysis. Drs Porter and Kimball were responsible for the study concept and design, as well as for critical revision of the manuscript for important intellectual content. Dr Kimball was responsible for study supervision. |
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| Reprint requests: clears@bidmc.harvard.edu. |
Vol 80 - N° 1
P. 114-119 - janvier 2019 Retour au numéro
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