Combination Treatment for Hidradenitis Suppurativa

Background: The treatment of hidradenitis suppurativa remains challenging, despite recent advances. A diverse range of management options, from lifestyle measures to monoclonal antibodies, are available and utilized based on disease severity and other patient factors. Increasingly, it is thought that combination therapy may be more adept in meeting the challenges of treatment of this multimodal disorder. Methods: A literature review of existing studies was performed. Eligible studies for the present review included case reports, case series, cohort studies or clinical trials in which patients with hidradenitis suppurativa were treated with a combination of two or more medical treatments. Abstracts, conference presentations, editorials, reviews, and expert opinions were excluded from analysis. Results: A total of 19 studies were identified from systematic database searches after applying inclusion and exclusion criteria. The majority of treatments documented are systemic antibiotic combinations, however a minority relate to topical and biological agents. The treatment combinations had varying degrees of efficacy. Conclusion: There is evidence that combination therapy is effective in the treatment of hidradenitis suppurativa. However the data is limited, and further, more robust, prospective studies with larger cohorts are required to reaffirm the findings in the present review.