Infection Risk among HS Patients Compared to Psoriasis: JAMA

Adults with moderate to severe hidradenitis suppurativa (HS) treated with adalimumab face a significantly higher risk of serious infections compared to those with psoriasis, according to a new cohort study published in JAMA Dermatology. Researchers analyzed U.S. insurance claims data of 10,349 adults initiating adalimumab between 2017–2020—1,650 with HS and 8,699 with psoriasis. They found that the HS group had a 53% higher hazard of hospitalization for noncutaneous infections (HR 1.53; 95% CI 1.34–1.86) after adjusting for confounders. Rates of sepsis (IRR 2.07; 95% CI 1.35–3.12) and genitourinary infections (IRR 2.22; 95% CI 1.22–3.86) were more than double in the HS cohort. HS patients also had a 28% higher odds of prolonged hospital stays (OR 1.28; 95% CI 1.13–1.45). Notably, HS patients were younger (mean age 36.2 vs. 46.5 years), more often female (77% vs. 50%), and had higher rates of obesity, Crohn’s disease, anxiety, and depression. The findings suggest that HS patients face a distinct infectious risk profile under immunosuppressive therapy compared to those with psoriasis. Researchers highlight the need for further studies to understand how disease severity, treatment regimens, and preventive strategies could mitigate this elevated infection risk. Until then, clinicians should remain vigilant when managing HS patients with adalimumab and consider close monitoring and tailored infection-prevention strategies.