Patients affected by a painful skin condition that causes painful abscesses and severe scarring have been given a lifeline thanks to a drug just made available by the NHS.
The shot, secukinumab, was given the green light after studies showed a reduction in symptoms of hidradenitis suppurativa (HS) by at least 50 percent after four months.
People struggling with the condition – also known as acne inversa – have historically ‘lost faith in medicine’ due to the lack of treatment options, says a spokesperson for health watchdog the National Institute for Health and Care Excellence (NICE).
The drug is sold under the name Consentyx and is taken weekly for the first month, and every four weeks thereafter. It is only the second drug that can combat HS. The first, adalimumab, was approved in 2016. It is hoped that secukinumab will save many HS patients from having to undergo surgery – which is often the only option once the disease progresses.
The condition is thought to affect one in 100 people and symptoms can range from mild to severe. The exact cause is unknown, but HS tends to crop up near the hair follicles where sweat glands are located – usually around the groin, buttocks, breasts and armpits.
The injection, secukinumab, was given the green light after studies showed at least a 50 percent reduction in symptoms of hidradenitis suppurativa (HS) after four months
‘HS can have a very significant impact on patients’ lives,’ says Dr John Ingram, consultant dermatologist at Cardiff University
For reasons also unknown, more women than men are affected, and there is no cure.
HS runs in families, is not contagious and is not the result of poor hygiene. It causes a mixture of boil-like lumps, blackheads, cysts and infected channels in the skin, known as sinus tracts, which can break out at the surface and ooze fluid. The lumps may also appear on the neck, waistband, and inner thighs.
‘HS can have a very significant impact on patients’ lives,’ says Dr John Ingram, consultant dermatologist at Cardiff University.
‘The pain is often severe and patients are constantly dealing with open wounds, which require daily dressings and can stain their clothes.
‘The development of skin scars can limit freedom of movement and has a major impact on the quality of life.
‘Until recently, there was no approved treatment for this condition and for many patients the current medicine is not effective enough or has become less effective over time.
‘It is incredibly welcome news that we now have a second option for our patients. Studies show that secukinumab is effective in reducing the number of inflamed abscesses patients experience, significantly reducing the amount of pain.”
According to the authors of the drug study, more than two-thirds of HS patients already have a moderate to severe disease at the time of initial diagnosis.
Existing treatment options include antibiotics, antiseptic detergents and retinoids. Medicines based on vitamin A are also prescribed by specialists to patients with severe acne. If the infections progress, surgery may be necessary to drain abscesses and ducts, remove the buildup of scar tissue, and steroid injections to reduce inflammation.
If adalimumab – an injectable drug that reduces levels of an inflammatory protein called tumor necrosis factor in the body – has no effect or stops working, NICE will now recommend that secukinumab be offered. The drug targets immune system proteins – called Interleukin 17A and Interleukin 17F – known to drive the inflammatory process.
Secukinumab and similar shots have proven remarkably effective in treating problem skin psoriasis and forms of inflammatory arthritis.
One patient hoping to get the jab is Angela Holland, 43, from Sunderland.
The municipal employee has lived at HS since she was ten, but it was not until she was 21 that she was finally diagnosed.
“I was too ashamed to tell anyone what I was going through,” she says. ‘I had abscesses on my arms, breasts and groin. It was so painful and meant I often missed school to hide the sores.’
Since her diagnosis 20 years ago, Angela has tried numerous treatments and different antibiotics, but nothing has been effective, including adalimumab. She now hopes that secukinumab will be effective against her crippling condition.
“My whole life has been limited by HS,” she says. ‘I’m desperate for a new drug that will make a difference.’