# Biologic therapy analysis and new HS management guidelines

> Live situation record from CLSTR: https://clstr.news/situations/biologic-therapy-analysis-for-hidradenitis-suppurativa
> Updated: 2026-10-20T18:06:24.000Z. Sources: 5. Developments: 4.

Recent medical analyses have evaluated the comparative effectiveness and cost-efficiency of biologic therapies for moderate-to-severe hidradenitis suppurativa (HS), specifically focusing on adalimumab, secukinumab, and bimekizumab.

An international economic evaluation found that adalimumab provided the most favorable balance between acquisition cost and clinical efficacy across several countries. Subsequent research indicated that bimekizumab showed higher odds of clinical response and greater quality-of-life improvements compared to secukinumab and adalimumab, though these results were not from direct head-to-head trials.

At the 2026 Fall Clinical Dermatology Conference, experts Iltefat Hamzavi, MD, and Jennifer Hsiao, MD, emphasized a comprehensive management approach involving structured symptom assessment, wound care, and screening for comorbidities like inflammatory bowel disease. While adalimumab, secukinumab, and bimekizumab are FDA-approved biologics, the oral JAK inhibitor povorcitinib remains under FDA review.

In a significant development, the American Academy of Dermatology (AAD) and the Hidradenitis Suppurativa Foundation (HSF) released the first joint clinical guidelines for HS management. Published in the Journal of the American Academy of Dermatology, the guidelines offer 37 evidence-based recommendations for patients aged nine and older. For moderate-to-severe cases, the guidelines issue a strong recommendation for biologic therapies, including adalimumab, bimekizumab, infliximab, and secukinumab, to reduce abscesses and nodules. Notably, the guidelines identify step therapy—an insurance practice requiring specific designated treatments before accessing preferred medications—as a primary barrier to care, noting it lacks evidence of clinical benefit and is linked to treatment delays and poorer outcomes.

## Timeline

### 2026-10-20: AAD and HSF issue first joint guidelines for hidradenitis suppurativa

The AAD and HSF have released the first joint clinical guidelines for hidradenitis suppurativa, identifying step therapy as a major barrier to care and strongly recommending specific biologic therapies.

3 sources. https://clstr.news/cluster/aad-and-hsf-issue-first-joint-guidelines-for-hidradenitis-suppurativa

### 2026-10-10: Dermatologists outline comprehensive management for hidradenitis suppurativa

Dermatology experts emphasize a multidisciplinary approach to hidradenitis suppurativa, combining symptom assessment and comorbidity screening with new biologic and JAK inhibitor treatments.

2 sources. https://clstr.news/cluster/dermatologists-outline-comprehensive-management-for-hidradenitis-suppurativa

### 2026-10-07: Biologic therapies for Hidradenitis Suppurativa undergo comparative analysis

Recent analyses and clinical discussions highlight bimekizumab's potential for superior clinical response in Hidradenitis Suppurativa compared to secukinumab and adalimumab, despite a lack of head-to-head data.

2 sources. https://clstr.news/cluster/biologic-therapies-for-hidradenitis-suppurativa-undergo-comparative-analysis

### 2026-09-28: Adalimumab identified as most cost-effective biologic for hidradenitis suppurativa

Research shows adalimumab offers an optimal balance of cost and efficacy for treating hidradenitis suppurativa, while clinicians emphasize individualized care combining biologics and surgical procedures.

2 sources. https://clstr.news/cluster/adalimumab-identified-as-most-cost-effective-biologic-for-hidradenitis-suppurativa

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Cite as: Biologic therapy analysis and new HS management guidelines. CLSTR, https://clstr.news/situations/biologic-therapy-analysis-for-hidradenitis-suppurativa