Clascoterone cream effective for patients with mild to moderate Hidradenitis suppurativa

Hidradenitis Suppurativa is an inflammatory skin condition linked with the overexpression of androgen receptors in areas of involvement. HS presents with several combinations of abscesses, inflammatory nodules, scarring, and tunnels. Despite being more common, mild HS is largely unstudied compared to moderate-severe. There is weak clinical evidence of the current therapy, therefore, there exists a therapeutic gap.

Clascoterone (cortexalone 17α-propionate; WINLEVI) is a novel androgen receptor antagonist which is available as a topical treatment. The medication has currently received approval from the US FDA for acne vulgaris and has been reported for use in treating androgenic alopecia. Clascoterone may be an effective treatment for HS lesions due to its anti-androgenic activity.

Abby Hargis, Eastern Virginia Medical School, Norfolk, Virginia, and colleagues analyzed the use of clascoterone 1% cream in patients with mild to moderate HS with stable disease or on no treatment in a retrospective chart review. 12 patients (7 patients with Hurley stage 1 disease, and 5 patients with stage 2 disease) compiled with the treatment and were followed up.

The researchers reported the following findings:

• After a median of 12 weeks of therapy, 83% demonstrated clinical improvement. Clinical improvement was defined as either documentation of patient-reported improvement and/or physician-documented improved physical examination findings.
• None of the 12 patients reported clinical worsening or had physician-documented clinical worsening.

"Our study showed the potential benefit of topical clascoterone 1% cream for patients with mild to moderate HS," the researchers wrote. "The findings highlight a need for future studies to evaluate clascoterone in mild to moderate HS patients and compare clascoterone cream with other commonly used topical HS treatments, such as clindamycin."

The study was limited by a majority female population (11 of the 12 participants), an uncontrolled design and a small sample size.

Reference:

Hargis, A., Yaghi, M., Maskan Bermudez, N., & Lev-Tov, H. (2023). Clascoterone in the Treatment of Mild Hidradenitis Suppurativa. Journal of the American Academy of Dermatology. https://doi.org/10.1016/j.jaad.2023.08.064