Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
Laura Levy, DHSc, PA-C
OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Does Adalimumab improve symptoms in patients with moderate to severe Hidradenitis Suppurativa?”
STUDY DESIGN: A systematic review of three peer-reviewed articles published between 2011 and 2016 which present patient oriented evidence.
DATA SOURCES: Review incorporated analysis of two randomized controlled trials (RCTs) and one open label prospective trial. Studies were selected based upon the relevance to the clinical question, does adalimumab usage improve symptoms in individuals with moderate to severe hidradenitis suppurativa.
OUTCOMES MEASURED: The outcomes measured focused on patient reported reduction in hidradenitis suppurativa symptoms. Two studies analyzed outcomes using patient reported Dermatology Life Quality Index (DLQI) scores, which take into account both physical and psychological disease burden as reported by the patient. The third study evaluated outcomes by analyzing the percentage of participants whom reported at least a 30% reduction in pain scores following adalimumab usage.
RESULTS: The open label trial completed by Sotiriou E, Goussi C, Lallas A, et al. revealed a significant improvement (P= 0.001) in patient reported DLQI scores following adalimumab usage for 24 weeks when compared to their initial DLQI scores. The study completed by Miller I, Lynggaard CD, Lophaven S, et al. failed to show statistically significant improvement in DLQI scores of patients receiving adalimumab compared to those receiving a placebo. The study by Kimball AB, Okun MM, Williams DA, et al. revealed inconsistent results concerning patient reported pain improvement with adalimumab use versus the use of a placebo.
CONCLUSION: Review of the three studies selected revealed inconclusive results. Though the results were inconsistent between studies, the presence of positive results in two of the studies indicates that further investigation of the efficacy of adalimumab use for hidradenitis suppurativa is warranted. Results from the studies analyzed indicate further research should also be carried out to evaluate the efficacy of simultaneous adalimumab and conventional therapeutic usage.
Eck, Eric A., "Does Adalimumab Improve Symptoms in Patients with Moderate to Severe Hidradenitis Suppurativa?" (2019). PCOM Physician Assistant Studies Student Scholarship. 447.