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The following is a summary of “Improvements in moderate-to-severe hidradenitis suppurativa with upadacitinib: Results from a phase 2, randomized, placebo-controlled study,” published in the February 2025 issue of Dermatology by Ackerman et al. 

Researchers conducted a prospective study to evaluate the efficacy and safety of upadacitinib, a selective Janus kinase inhibitor, for treating hidradenitis suppurativa (HS).  

They enrolled adults with moderate-to-severe HS, who were randomized 2:1 to receive once-daily upadacitinib 30 mg or placebo. After 12 weeks, placebo recipients switched to blinded upadacitinib 15 mg, while those on upadacitinib 30 mg continued treatment through week 48. The primary endpoint was a ≥50% decline in total abscess and inflammatory nodule count with no increase in abscess or draining fistula count compared to baseline (Hidradenitis Suppurativa Clinical Response [HiSCR50]) at week 12.  

The results showed that 47 patients received upadacitinib and 21 received placebo, at week 12, a significantly higher percentage of upadacitinib recipients achieved HiSCR50 compared to the historical placebo rate (38.3% vs 25.0%, 1-sided P=.018). The adjusted difference with the in-trial placebo group was 14.7% (nominal P=.087) while, HiSCR50 achievement with upadacitinib was consistent across baseline Hurley stage and prior tumor necrosis factor inhibitor use and was maintained through week 40. Upadacitinib’s safety profile was in line with previous reports on dermatological conditions.  

Investigators concluded that the findings supported further research into the use of upadacitinib for the treatment of moderate-to-severe HS. 

Source: jaad.org/article/S0190-9622(25)00190-2/abstract