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How good is the evidence to support the various topical and systemic treatments used for patients with hidradenitis suppurativa? In a May 2016 Cochrane systematic review, researchers found only 12 randomized, controlled trials, in which 15 different treatments were examined in 615 adults. “Moderate-quality evidence” from small phase 2 trials supported the effectiveness of two tumor necrosis factor (TNF) inhibitors, adalimumab (Humira) and infliximab (Remicade). Evidence was inadequate to draw confident conclusions about common therapies such as topical or systemic antibiotics.
Now, results of two industry-sponsored, phase 3 randomized trials of adalimumab (not included in the Cochrane review) have been published. More than 600 patients with …