Cost-effectiveness of Adalimumab and Surgery vs Adalimumab in HS (HS-COST)
Hidradenitis Suppurativa
About this trial
This is an interventional treatment trial for Hidradenitis Suppurativa focused on measuring Acne inversa, Adalimumab, Cost-effectiveness
Eligibility Criteria
Inclusion Criteria:
- Age ≥18 years.
- Moderate to (very) severe HS defined as a score of ≥3 points on the PGA (range 1-5) and with a DLQI of at least 11 (range 0-30).
- Indication for adalimumab: i.e. uncontrolled disease (HS) under conventional therapy and/or minor surgery.
- A diagnosis of HS for more than six months prior to baseline.
- Clearance of HS can reasonably be achieved with three surgical interventions as based on consensus between two dermatosurgeons.
- Willing and able to undergo general anaesthesia or procedural sedation and analgesia.
- Able and willing to give written informed consent and to comply with the study requirements.
Exclusion Criteria:
- Contraindication for treatment with adalimumab (sepsis or risk of sepsis, active or latent tuberculosis, serious active local and/or chronic infections, heart failure NYHA class III/IV, severe liver disease, pre-existing HIV, active viral hepatitis, demyelinating disease, or allergy to adalimumab or any other ingredients of HUMIRA®).
- Previous or current use of adalimumab or other anti-TNF-α therapy.
- Current or recurrent clinically significant skin condition in the HS treatment area other than HS.
- Presence of other uncontrolled clinically significant major disease.
- Pregnant and lactating women.
- Malignancy (except basal cell carcinoma), lymphoproliferative disease or a history of malignancy.
- Current use of oral antibiotics (a washout period of 14 days is required).
- Current use of oral corticosteroids (a washout period of 30 days is required).
Sites / Locations
- Erasmus MCRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Adalimumab Monotherapy
Adalimumab + Surgery
Adalimumab injections will be administered through subcutaneously in a weekly dose of 40mg from week 4 up to 24 months (V8), after an initial dose of 160mg at week 0 and a 80mg dose at week 2, continued for 2 years in total.
Patients will be treated with a combination of adalimumab and wide excision, with a maximum of three surgical interventions within the first year. Adalimumab will be administered through subcutaneous injections in weekly dose of 40mg from week 4 up to 24 months (V8), after an initial dose of 160mg at week 0 and a 80mg dose at week 2, continued until the last surgery.