OBJECTIVES: The objective of this research was to characterize real-world treatment patterns among hidradenitis suppurativa (HS) patients in diverse healthcare delivery settings in the United States (US).

METHODS: Patients from 6 specialty dermatology networks and 4 integrated delivery networks within the OMNY Health Database with any indication of HS (diagnosis code: L73.2) from 2014-2021 were included. Demographic characteristics were tabulated at first HS diagnosis. Percentages of patients with prescriptions or procedures for the following treatments were computed: topical clindamycin (TC), systemic antibiotics and immunomodulators (SAI), adalimumab, incision/drainage, excision, laser, and photodynamic therapy. Secular trends in annual treatment patterns were described.

RESULTS: Across all years, a total of 24,933 HS patients with prescription and procedure data were included. Distributions of gender (77% female), race (70% White, 21% Black, 9% Other among known categories), age (13% ≥ 61 years, 76% 21-60 years, 11% ≤ 20 years), and region (65% South, 17% Midwest, 14% West, 3% Northeast) were as expected. Among the 14% of patients with valid body mass index values, 59% were obese, 23% were overweight, and 18% were healthy/underweight. Patient percentages ranged from 42% to 53% for TC and from 43% to 69% for SAI. From 2014 to 2021, adalimumab use increased from 1% to 12% while incision/drainage procedures decreased from 10% to 5%. Laser surgeries decreased steadily from 18% in 2017 to 10% in 2021. Photodynamic therapy and excision procedures were both negligible over the observation period.

CONCLUSIONS: Results provide insights into real-world treatment patterns for HS within a diverse set of US healthcare settings. Adalimumab use has increased steadily since the Food and Drug Administration approval for the treatment of HS, while incision/drainage procedures have declined. As new treatments are developed and introduced, future analyses would be helpful to understand uptake of therapies and prescription patterns among HS patients.