Infection risk higher in adalimumab users with HS vs psoriasis

Among adults receiving adalimumab treatment, those with hidradenitis suppurativa (HS) appear to be at greater risk of infection than their psoriasis counterparts, as reported in a retrospective study.

Researchers used data from the MarketScan database and identified adult patients with HS or psoriasis who initiated adalimumab therapy.

The primary outcome was hospitalization from noncutaneous infections, which was assessed using a time-to-event analysis with inverse probability weighting to account for confounders. Secondary outcomes included the infection types and length of hospital stay.

A total of 10,349 patients (mean age 44.8 years, 54.5 percent female) were included in the analysis. Of these, 1,650 had HS and 8,699 had psoriasis. Compared with the psoriasis cohort, the HS cohort was younger (mean age, 36.2 vs 46.5 years) and were more likely to be female (77 percent vs 50.2 percent), with higher rates of obesity, Crohn disease, anxiety, and depression.

Weighted Cox regression models showed an elevated risk of serious infection in the HS vs the psoriasis cohort (hazard ratio, 1.53, 95 percent confidence interval [CI], 1.34–1.86), especially sepsis (incidence rate ratio [IRR], 2.07, 95 percent CI, 1.35–3.12) and genitourinary infections (IRR, 2.22, 95 percent CI, 1.22–3.86).

Furthermore, the HS cohort had greater odds of prolonged hospital stay than the psoriasis cohort (odds ratio, 1.28, 95 percent CI, 1.13–1.45).

The findings underscore the need to focus on the impact of disease severity and treatment regimens on infection risk and develop targeted prevention strategies in future studies.