Biologics and patient survival in hidradenitis suppurativa: The Mayo Clinic experience

Summary: Abstract Body: Biologics are a mainstay of treatment for hidradenitis suppurativa (HS). To identify whether treatment with biologics was associated with differences in healthcare outcomes, patient demographics, and insurance status, we utilized the Mayo Clinic Platform Discover database, encompassing over 7.3 million patients across Minnesota, Arizona, and Florida. Propensity score matching was conducted to compare HS patients treated with biologics (adalimumab, infliximab, or secukinumab) to those not treated with biologics, controlling for age, sex, race, and ethnicity. Of the 9158 HS patients in the database, 1634 were included after matching. The biologics group and non-biologics group had mean ages of 37.2 and 37.0 years, respectively. Obesity prevalence was similar (39% vs. 43%, p=0.087). However, the biologics group had significantly lower rates of non-insurance (14.8% vs. 27.2%, p<0.0001), Medicaid coverage (21.9% vs. 32.1%, p<0.0001), and government insurance excluding Medicaid and Medicare (15.3% vs. 24.1%, p<0.0001). Biologics were associated with a significant increase in 60-month survival (CI: 1.04–5.96, p=0.034) and a substantial reduction in mortality (1.5% vs. 6.5%, p<0.0001), though hospitalization rates did not differ significantly (41.9% vs. 42.0%, p=0.96). In a sub-analysis of non-white patients, biologics were associated with a significant reduction in hospitalizations (26.3% vs. 38.7%, p=0.028), a group previously reported to face over double the risk of hospitalization. Our findings suggest that biologics improve survival and reduce mortality in HS patients, with notable benefits for non-white populations, who experienced fewer hospitalizations. However, higher rates of insurance and commercial coverage among biologic patients may confound these results, underscoring the need for further research to better understand these associations. Samantha C. Shao¹, Sarah Amjad¹, Stella Chen² 1. Mayo Clinic School of Medicine - Scottsdale Campus, Scottsdale, AZ, United States. 2. Department of Dermatology, Mayo Clinic Arizona, Scottsdale, AZ, United States. Clinical Research: Epidemiology and Observational Research