Additional Long-Term Data on IL-17 Inhibitors in HS

Long-term secukinumab data extend to 4 years with a complex trial design involving treatment withdrawal periods that revealed important insights about disease behavior and drug properties. The study demonstrated that many patients who lost response during withdrawal or dose reduction could recapture therapeutic benefit when returned to more frequent dosing, with some nonresponders at earlier time points achieving significant improvement with continued treatment over extended periods. This pattern differs markedly from TNF inhibitor experience, where treatment interruption often leads to antibody development and loss of response upon reinitiation.

The low immunogenicity profile of IL-17 inhibitors represents a major clinical advantage, allowing patients who experience insurance lapses or other treatment interruptions to successfully restart therapy and regain disease control. This characteristic proves particularly valuable for patients in unstable employment situations or those experiencing life changes that temporarily interrupt access to medication. In clinical practice, patients who discontinue IL-17 inhibitors and subsequently flare can typically recapture their previous response level when treatment resumes, though the timeline for improvement follows the original 3- to 6-month pattern.

Patient counseling around long-term IL-17 inhibitor use acknowledges the chronic nature of hidradenitis suppurativa (HS) while emphasizing the flexibility these medications offer compared to TNF inhibitors. Practitioners frame treatment as likely lifelong but stress that if life circumstances necessitate breaks, the ability to regain response remains high, reducing anxiety about indefinite commitment to therapy. This message helps address common patient concerns about permanent medication dependence while maintaining realistic expectations about the chronic disease requiring ongoing management for sustained benefit.