Dose Boost Helps Stubborn Hidradenitis Patients
A retrospective French study found dose intensification and antibiotics improved outcomes for patients with insufficient biologic response.
Updated on Nov. 4, 2026 in Beauty
Researchers reported in JAMA Dermatology that among 107 hidradenitis suppurativa patients at a French tertiary dermatology center, those with an end-of-dose effect received dose intensification while others received antibiotics. Mean IHS4 scores fell from 7.0 to 3.9 at 3 to 5 months, and no serious adverse events were reported.
Why it matters
Hidradenitis suppurativa is a painful, chronic skin condition, and many patients respond insufficiently to standard biologic therapy. The study proposes the end-of-dose effect as a possible tool to guide which optimization strategy to choose.
The study covered 107 patients, with a mean age of 31.7 years and 75.5% having severe disease, and 53.8% of 93 evaluable patients achieved an IHS4 response. Because the design is retrospective and attrition reached 39% by 6 to 12 months, the durability of these gains remains unconfirmed.
The players
JAMA Dermatology
A peer-reviewed journal of the American Medical Association that publishes clinical and research studies in dermatology.
The details
Patients with an insufficient response, defined as 0.33 or more flares per month after at least 3 months of standard-dose biologic therapy, were divided by whether they showed an end-of-dose effect, meaning disease activity recurred before the next injection. Those with the effect received dose intensification (n = 52), while those without received doxycycline or trimethoprim-sulfamethoxazole (n = 50), with five patients receiving both.
Timeline
January 2022: Patient enrollment began at the French dermatology center.
March 2025: Patient enrollment ended.
3 to 5 months: Primary IHS4 response was assessed.
6 to 12 months: Sustained improvement was assessed.
November 4, 2026: The study was published online in JAMA Dermatology.
Health Landscape
The study reflects a shift toward phenotype-guided treatment for hidradenitis suppurativa, where clinicians try to match patients to optimization strategies rather than applying one approach. It also highlights the IHS4 scoring system as a common yardstick for judging response across such studies.
Patients who do not respond well to standard biologic therapy may find that dose adjustments or antibiotics are options to discuss with a dermatologist. The study reported no serious adverse events, though it was retrospective and single-center, so these strategies have not been confirmed in larger trials.
The takeaway
Treatment for hidradenitis suppurativa may be refined by identifying patients who experience end-of-dose recurrence and tailoring their optimization strategy. Confirmation through prospective trials remains the next necessary step before these approaches become standard.
Further reading
Explore more in Beauty for related coverage of skin health and treatment trends.
