Real-World Evidence Reveals Key Insights on Hidradenitis Suppurativa

Alexa B. Kimball, MD, MPH,

Target RWE, a real-world evidence research organization, presented new data on hidradenitis suppurativa (HS) from its longitudinal dermatology registry at the 2025 American Academy of Dermatology (AAD) annual meeting in Orlando, Florida.¹

The insights from a registry of 7,000 enrolled patients, including over 400 with HS, were summarized in two posters highlighting different challenges of managing patients with HS: odor severity, delayed diagnosis, and potential disparities in care.¹

Odor Severity Linked to Worse Outcomes

A poster titled Characterization of Patient Perception of Odor Severity in Hidradenitis Suppurativa Using TARGET-DERM HS examined factors contributing to odor severity in HS. Investigators found that odor severity was significantly higher in male participants and those with a longer disease duration. Moreover, increased disease severity, lesion count, flare frequency, and drainage severity were all associated with greater odor severity, even in patients without abscesses or fistulas.¹

The study also linked higher odor severity with poorer quality of life and increased prevalence of depression and anxiety.

"The findings underscore the benefits of integrating patient perspectives when assessing the impact of HS and the need for improved access to timely diagnosis and equitable treatment strategies for patients, particularly among underserved populations," said Alexa B. Kimball, MD, MPH, CEO and President of Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center, in a company news release. "Through a patient-centered approach, we develop effective interventions that address both clinical and psychosocial dimensions of this challenging condition." Dr. Kimball is also the TARGET-DERM HS steering committee chair and co-author of the study.¹

Delayed Diagnosis and Treatment Disparities

A second poster, Healthcare Disparities in Hidradenitis Suppurativa in the US: TARGET-DERM HS, evaluated real-world clinical data and patient-reported outcomes to examine differences in disease burden and treatment patterns.¹

Key findings included:

• A significant delay in diagnosis and treatment initiation; patients often waited nearly a decade before starting biologic therapy.
• Non-Hispanic Black participants had the highest mean disease severity (Hurley score 2.1), higher rates of diabetes (31.6%) and obesity (42.1%), and the lowest rate of private insurance (53.4%). This group, however, was the most likely to use biologic therapy (50.5%).
• In contrast, Hispanic participants relied more on topical antiseptics and alternative treatments and had lower rates of biologic use (31.3%).
• Depression was more prevalent in non-Hispanic White participants (35.1%).¹

"We're immensely proud of our dermatology registry of over 7,000 enrolled patients across diverse demographics and clinical presentations," said Michael W. Fried, MD, FAASLD, Co-Founder and Chief Medical Officer at Target RWE, in the news release. "This diversity enables researchers to identify disparities in care, understand disease burden across different populations, and ultimately develop more equitable treatment approaches. The robustness of our patient population positions our data as an invaluable resource for advancing RWE in dermatology and improving outcomes."¹

Emerging Targeted Therapies for HS

The introduction of targeted therapies for HS, including TNF inhibitors, IL-12/23 inhibitors, and JAK inhibitors, has substantially broadened treatment options and improved disease outcomes, according to a January 2024 report from Biospace.²

These pharmacologic advances are associated with decreased flare frequency, minimized adverse effects, and enhanced patient quality of life. Ongoing research and development have driven competition among pharmaceutical companies, increasing the availability of both oral and topical agents that enable personalized treatment regimens. Expedited regulatory approval of biologics, such as adalimumab, has further accelerated market growth and fostered interdisciplinary collaboration among dermatology, immunology, and wound care specialists. As healthcare professionals increasingly recognize HS and implement patient-centered strategies, investment in novel therapies is anticipated to surge, ultimately improving accessibility and satisfaction for affected patients.²

References

1. Patient-Centric Data Capture Fuels Growth of Target RWE Longitudinal Real-World Dermatology Studies. PR Newswire. Accessed March 7, 2025. https://prnmedia.prnewswire.com/news-releases/patient-centric-data-capture-fuels-growth-of-target-rwe-longitudinal-real-world-dermatology-studies-302395567.html

2. Hidradenitis Suppurativa Market Size to Reach USD 4.6 Billion by 2035, Impelled by Awareness Expansion and Better Treatment Access. BioSpace. Accessed March 7, 2025. https://www.biospace.com/press-releases/hidradenitis-suppurativa-market-size-to-reach-usd-4-6-billion-by-2035-impelled-by-awareness-expansion-and-better-treatment-access