Staphylococcus aureus Carriage in Hidradenitis Suppurativa: Impact on Response to Adalimumab

Autor:	Theodora Kanni, Dimitra Stergianou, Pantelis G. Bagos, Maria D. Argyropoulou, Evangelos J. Giamarellos-Bourboulis, Vassiliki Tzanetakou
Rok vydání:	2021
Předmět:	medicine.medical_specialty business.industry Dermatology Odds ratio medicine.disease_cause medicine.disease Gastroenterology Carriage Staphylococcus aureus Internal medicine medicine Adalimumab Positive culture Hidradenitis suppurativa Stage (cooking) business Whole blood medicine.drug
Zdroj:	Dermatology. 237:372-377
ISSN:	1421-9832 1018-8665
Popis:	Background: Several patients with hidradenitis suppurativa (HS) present flare-ups during treatment with adalimumab (ADA), the cause of which is not clear. ADA is the only FDA-approved biologic for the therapy of moderate-to-severe HS. A previous study of our group has shown that Staphylococcus aureus stimulation of whole blood affects the production of human β-defensin 2 and modulates HS severity. It is, therefore, hypothesized, that carriage of S. aureus may drive HS flare-ups. Objective: To explore the association between carriage of S. aureus and loss of response to ADA. Patients and Methods: Among patients with moderate-to-severe HS without carriage of S. aureus at start of treatment with ADA, we investigated for carriage of S. aureus from the nares when flare-ups occurred. Flare-ups were pre-defined as at least 25% increase of inflammatory lesions (sum of inflammatory nodules and abscesses) from baseline. Samplings were also done after completion of 12 weeks of ADA treatment from all patients who did not present flare-ups. Clinical response to ADA was assessed by the HS Clinical Response score (HiSCR). Results: Thirty-nine patients were studied; 24 with Hurley II stage HS and 15 with Hurley III stage HS. Twenty-nine patients achieved HiSCR after 12 weeks of treatment without any flare-ups; 10 patients had flare-ups and failed HiSCR. Three (10.3%) and 5 (50%) patients, respectively, had nasal carriage of S. aureus (odds ratio 8.67; 95% CI 1.54–48.49; p = 0.014). Among 32 patients reaching follow-up week 48, 20 patients achieved HiSCR and 12 had flare-ups leading to ADA failure; 2 (10%) and 5 (41.7%) patients, respectively, had positive culture for S. aureus (odds ratio 6.42; 95% CI 1.00–41.20; p = 0.05). Conclusion: Nasal carriage of S. aureus may be associated with loss of response to ADA. Findings need confirmation in larger series of patients.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::0a0b237c5934f1259793dd7a42f23dbe https://doi.org/10.1159/000512617 Zobrazit plný text záznamu