Impact of increased infliximab infusion frequency on disease severity and pain in hidradenitis suppurativa: A retrospective study

Summary: Abstract Body: Patients with hidradenitis suppurativa (HS) often experience disease flares in the week preceding scheduled infliximab infusions, raising concerns about whether a shorter interval between infusions may provide relief and clinical benefit. This study evaluated the impact of increasing infliximab infusion frequency from every 4 weeks to every 3 weeks on disease severity and patient-reported outcomes. We conducted a retrospective cohort study of 27 patients who underwent this modified infliximab regimen. Patient demographics included 55.55% male, 51.85% Black, 18.51% Hispanic, and 44.44% with private insurance. The mean age was 34.74 ± 13.74 years, mean BMI was 33.88 ± 7.78, and mean Hurley stage was 2.87 ± 0.34. Patients were followed for a mean period of 734.07 ± 614.39 days. Patient-reported outcomes indicated that 74.07% experienced some to major improvement, while the remainder reported no improvement. Statistically significant reductions were observed in disease severity, with overall HS physician global assessment (HS-PGA) scores decreasing from 3.59 to 2.70 (p<0.001), minimum HS-PGA from 3.2 to 2.4 (p=0.003), and maximum HS-PGA from 4.72 to 3.92. Pain outcomes showed improvement, with minimum numeric rating scale (NRS) pain decreasing from 1.8 to 0.64 (p<0.05), though reductions in maximum NRS pain (p=0.052) did not reach statistical significance. No side effects were reported. These findings suggest that increasing the frequency of infliximab infusions from 4 to 3 weeks can significantly improve HS disease severity and reduce pain in many patients, particularly those who report pre-infusion flares. This adjustment may provide a valuable strategy for optimizing infliximab efficacy in patients who report breakout flares in the week leading up to their infusion. Further studies are needed to validate these findings in larger cohorts and explore long-term outcomes. Zahidul Islam¹, Daniel S. Alicea², Jasmine Wong², David Ciocon² 1. School of Medicine, New York Medical College, Valhalla, NY, United States. 2. Dermatology, Montefiore Medical Center, New York, NY, United States. Clinical Research: Interventional Research