Non-Antibiotic and Non-Biologic Systemic Therapeutics
The pathophysiology of hidradenitis suppurativa (HS) has yet to be fully established. Hyperandrogenism, insulin resistance, and aberrant immune responses are all thought to play an important role in HS. Although many questions remain, our current understanding of this complex pathophysiology has helped formulate a multifaceted approach to therapy. This chapter will present published data supporting the use of systemic non-antibiotic agents targeting pathways relevant to HS. For most of these therapies, there remains a lack of high-level evidence to support their use, and data is largely limited to case reports, retrospective studies, and small prospective studies. Although promising results have been reported for several therapies, randomized controlled trials are needed to further establish their roles in the management of HS.