Biologics are medications that are produced via biological processes involving recombinant DNA technology. Biologics are generally reserved for severe cases of hidradenitis suppurativa, and may be effective in a significant number of these cases.
Currently the only FDA-approved biologic is adalimumab (Humira). However, there is data to support the use of other biologics such as ustekinumab (Stelara), anakinra (Kineret) and infliximab (Remicade). Adalimumab and anakinra are injected by patients at home, ustekinumab may be injected at home or at the dermatologist’s office, and infliximab is administered at infusion centers intravenously.
Biologics are costly and typically patients must fail other medications, in order to be considered for biologics. Furthermore, biologics may have side effects, including serious infection, tuberculosis reactivation, lymphoma, and injection site reactions, which require discussion with a dermatologist.
As hidradenitis suppurativa is a chronic disease, biologics may be used indefinitely. Over 50% of severe patients may achieve an impressive response to these agents.