Τίτλος:
Staphylococcus aureus Carriage in Hidradenitis Suppurativa: Impact on Response to Adalimumab
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Several patients with hidradenitis suppurativa (HS) present flare-ups during treatment with adalimumab (ADA), the cause of which is not clear. ADA is the only FDA-approved biologic for the therapy of moderate-to-severe HS. A previous study of our group has shown that Staphylococcus aureus stimulation of whole blood affects the production of human β-defensin 2 and modulates HS severity. It is, therefore, hypothesized, that carriage of S. aureus may drive HS flare-ups. Objective: To explore the association between carriage of S. aureus and loss of response to ADA. Patients and Methods: Among patients with moderate-to-severe HS without carriage of S. aureus at start of treatment with ADA, we investigated for carriage of S. aureus from the nares when flare-ups occurred. Flare-ups were pre-defined as at least 25% increase of inflammatory lesions (sum of inflammatory nodules and abscesses) from baseline. Samplings were also done after completion of 12 weeks of ADA treatment from all patients who did not present flare-ups. Clinical response to ADA was assessed by the HS Clinical Response score (HiSCR). Results: Thirty-nine patients were studied; 24 with Hurley II stage HS and 15 with Hurley III stage HS. Twenty-nine patients achieved HiSCR after 12 weeks of treatment without any flare-ups; 10 patients had flare-ups and failed HiSCR. Three (10.3%) and 5 (50%) patients, respectively, had nasal carriage of S. aureus (odds ratio 8.67; 95% CI 1.54-48.49; p = 0.014). Among 32 patients reaching follow-up week 48, 20 patients achieved HiSCR and 12 had flare-ups leading to ADA failure; 2 (10%) and 5 (41.7%) patients, respectively, had positive culture for S. aureus (odds ratio 6.42; 95% CI 1.00-41.20; p = 0.05). Conclusion: Nasal carriage of S. aureus may be associated with loss of response to ADA. Findings need confirmation in larger series of patients. © 2021
Συγγραφείς:
Stergianou, D.
Tzanetakou, V.
Argyropoulou, M.
Kanni, T.
Bagos, P.G.
Giamarellos-Bourboulis, E.J.
Περιοδικό:
Dermatology World
Λέξεις-κλειδιά:
adalimumab; amoxicillin plus clavulanic acid; clindamycin; cloxacillin; meticillin; moxifloxacin; adalimumab; antiinflammatory agent, adult; antibiotic sensitivity; antibiotic therapy; Article; bacterial colonization; bacterium culture; clinical article; cohort analysis; controlled study; disease classification; disease severity; drug withdrawal; exploratory research; female; follow up; Hidradenitis Suppurativa Clinical Response score; human; Hurley stage; incidence; inflammation; male; nose; nose smear; observational study; priority journal; recurrent disease; retrospective study; skin abscess; skin disease assessment; skin nodule; Staphylococcus aureus; Staphylococcus aureus infection; suppurative hidradenitis; treatment response; unspecified side effect; epidemiology; heterozygote; isolation and purification; microbiology; middle aged; nose cavity; Staphylococcus aureus; suppurative hidradenitis; young adult, Adalimumab; Adult; Anti-Inflammatory Agents; Carrier State; Female; Hidradenitis Suppurativa; Humans; Incidence; Male; Middle Aged; Nasal Cavity; Retrospective Studies; Staphylococcus aureus; Young Adult
