Hidradenitis suppurativa (HS) is a recurrent chronic inflammatory disease marked by painful lesions in intertriginous regions. Recent studies highlight neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and C-reactive protein (CRP) as systemic inflammation markers correlated with disease severity. This study aimed to analyse changes in inflammatory parameters in HS patients pre- and post-16-week adalimumab treatment. We sought to understand if changes in these parameters have any correlation with response to treatment. A retrospective cohort of 44 adalimumab-treated HS patients was used to evaluate laboratory (NLR, PLR, MLR, CRP) and clinical (DLQI, IHS4, IHS4-55 and PI-NRS) parameters. Data, collected between 2019 and 2023, underwent statistical analysis including t-tests, Wilcoxon signed-rank tests and Pearson correlation tests, comparing pre- and post-treatment values. Adalimumab treatment led to a significant improvement in HS inflammatory markers. Clinical scores, including DLQI, (p<0.0001), IHS4 (p<0.0001) and PI-NRS (p<0.0001), showed significant reduction post-treatment. Analytical variables, NLR (p=0.02), PLR (p=0.02), CRP median (p=0.01), and MLR median (p=0.027), also exhibited significant decreases. In most patients, IHS4-55 scores did not show a 55% reduction. No significant correlation was found between baseline clinical scores and inflammatory parameters. All systemic inflammation-based biomarkers were significantly reduced after starting adalimumab. The clinical scores of DLQI, IHS4 and PI-NRS were also significantly decreased. Contrarily, in most patients, the IHS4-55 score did not show a 55% reduction. This suggests that haematological markers of inflammation may predict response to treatment with adalimumab.
Keywords: adalimumab; clinical dermatology; hidradenitis suppurativa; inflammatory response.