Golimumab Shows Promise in Treatment-Resistant Hidradenitis Suppurativa: JAMA
USA: A study published in JAMA Dermatology found that more than half of patients with treatment-resistant hidradenitis suppurativa (HS) achieved at least a 55% improvement in disease severity after golimumab, a tumor necrosis factor (TNF) inhibitor, treatment. Notably, patients responded to golimumab despite previous treatment with other TNF inhibitors.
Given its higher TNF-binding affinity and flexible administration options, golimumab may represent a promising therapeutic alternative for patients with refractory HS. However, further studies are needed to confirm its efficacy and long-term safety.
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by painful nodules, abscesses, and sinus tracts, affecting approximately 0.7% to 1.2% of the population. Despite the use of TNF inhibitors, treatment options remain limited, with adalimumab being the only FDA-approved TNF inhibitor for HS. Loss of treatment response is common, highlighting the need for additional therapeutic options.
To assess the effectiveness of golimumab in treatment-refractory HS, researchers led by Madeline Sage, BS, and Christopher J. Sayed, MD, from the Department of Dermatology, University of North Carolina, Chapel Hill, conducted a retrospective review of electronic medical records. The study included 27 patients (mean age 41.3 years; 85.2% women) who received golimumab for at least 10 weeks between January 2017 and December 2025 at doses of 200–300 mg every three to four weeks.
The following were the key findings:
- 51.9% of patients achieved the primary endpoint of a 55% improvement in the International Hidradenitis Suppurativa Severity Score System (IHS4-55).
- Among patients who responded to treatment, 58.8% received intravenous golimumab, while 40% received the subcutaneous formulation.
- Responders showed a reduction in their mean IHS4 score from 28.9 at baseline to 18.6 at the first follow-up, conducted at least 10 weeks after treatment initiation.
- Nine patients achieved the IHS4-55 target within 12 months of starting golimumab therapy.
- Thirteen patients achieved the secondary endpoint of Hidradenitis Suppurativa Clinical Response (HiSCR).
- Ten responders were receiving concomitant systemic therapies, most commonly antibiotics, when clinical improvement was observed.
- Golimumab was generally well tolerated, with one patient developing psoriasiform dermatitis and one developing arthralgia during treatment.
- No other major safety concerns were reported during the study.
The researchers noted that patients received higher or more frequent golimumab doses than those reported in previous studies, suggesting that dose escalation may be necessary for severe, treatment-refractory HS. Notably, many patients responded despite prior treatment with other TNF inhibitors, indicating that switching within the TNF inhibitor class may still provide clinical benefit. The authors concluded that larger prospective studies are needed to further evaluate golimumab as a treatment option for refractory HS.
Reference:
Sage M, Sayed CJ. Golimumab in Treatment-Refractory Hidradenitis Suppurativa. JAMA Dermatol. Published online June 10, 2026. doi:10.1001/jamadermatol.2026.1457
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