Cross-Sectional Analysis of Biologic Use in the Treatment of Veterans With Hidradenitis Suppurativa.

BACKGROUND: Biologic medications, such as adalimumab, secukinumab, and bimekizumab, are currently the only medications approved by the US Food and Drug Administration for the treatment of hidradenitis suppurativa (HS). Low rates of biologic use in HS have been reported, with significant differences in prescription patterns by sex, race, and age. However, no studies have analyzed these metrics in the Veterans Health Administration (VHA). This study evaluated HS therapy in the VHA and potential disparities in biologic prescription patterns for patients. METHODS: This retrospective cross-sectional analysis used VHA data from January 1, 2011, to December 31, 2021. Biologic prescriptions, including adalimumab and infliximab, were analyzed across varying patient demographics and characteristics. RESULTS: In VHA, 29,483 individuals had ≥ 1 diagnosis of HS, of whom 5.2% were prescribed ≥ 1 biologic (adalimumab or infliximab). Most patients diagnosed with HS were White (60.6%), men (75.3%), and obese (59.3%) and had prior or current tobacco use (73.5%). An age-dependent reduction in the odds of being prescribed a biologic in patients with HS (P < .001) was observed. Obesity (body mass index ≥ 30) significantly increased the odds of biologic prescription (P < .001). CONCLUSIONS: Biologic use in patients with HS was relatively low but higher or within the same range as previous studies. Understanding biologic prescription patterns offers potential to identify and improve access to underserved HS populations.