An assessment of current practices in the treatment of hidradenitis suppurativa: the rise of biologic therapy

Introduction: Treatments for hidradenitis suppurativa (HS) have changed in the last decade. In this context, we studied how management practices have shifted. Methods: We analyzed the National Ambulatory Medical Care Survey (NAMCS) from 2010 to 2016 to assess current treatment practices for HS. Results: There were 1.78 (95% confidence interval 1.35, 2.22) million visits. Antibiotics were observed at 55.7% of visits and observations remained stable over time (p =.9, odds ratio 0.99 [0.73, 1.3]). Pain medications were observed at 15.5% of visits and observations remained stable over time (p =.4, odds ratio [0.87 [0.61, 1.2]). Biologic agents were observed at 0.9% of visits and observations remained stable over time (p =.4, odds ratio 0.61 [0.21, 1.7]). Systemic immunomodulators were observed at 2.6% of visits and observations remained stable over time (p =.08, odds ratio 0.42 [0.12, 1.1]). 100% of biologic agents and 88% of systemic immunomodulators were prescribed by dermatologists. Discussion: The use of biologic agents did not increase in this interval, but it is higher than in an earlier assessment of the NAMCS. Nearly all systemic immunomodulators are prescribed by dermatologists. The ambulatory uptake of these agents did not alter the use of other treatment modalities within this timeframe.