Background

Hormonal therapy is a potential treatment for hidradenitis suppurativa (HS). However, few data exist describing the efficacy of spironolactone in treatment of HS.

Objective

To assess whether spironolactone treatment improves HS disease severity and patient-reported pain.

Methods

We performed a single-center chart review of female patients with HS who were treated with spironolactone between 2000 and 2017. Primary outcome measurements included the HS Physician's Global Assessment (HS-PGA), Hurley staging, inflammatory lesion count, fistula count, and a numeric rating scale for pain.

Results

On average, subjects were exposed to 75 mg of spironolactone daily over a 7.1-month follow-up period. Patients achieved significant disease improvement with regard to pain (Δ-1.5 [P = .01]), inflammatory lesions (Δ-1.3 [P = .02]), and HS-PGA score (Δ-0.6 [P < .001]). As expected, no change was found for Hurley stage (Δ0 [P = .32]) or fistulas (Δ0 [P = .73]). There was no difference in improvement between subjects who received less than 75 mg of spironolactone daily (n = 25; average dose, 45 mg/d) and those who received more than 100 mg daily (n = 21; average dose, 112 mg/d).

Limitations

Retrospective nature, limited sample size, and variations in severity measures documented were limiting factors.

Conclusions

Management of HS with spironolactone reduces lesion count, HS-PGA score, and pain. Lower doses appear to be effective and may be an appropriate option for patients with tolerability concerns.

中文翻译：

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螺内酯抗雄激素疗法治疗化脓性汗腺炎

背景

激素疗法是化脓性汗腺炎（HS）的潜在疗法。但是，很少有数据描述螺内酯在治疗HS中的功效。

客观的

评估螺内酯治疗是否可以改善HS疾病的严重程度和患者报告的疼痛。

方法

我们对2000年至2017年间接受螺内酯治疗的HS女性女性进行了单中心图表审查。主要结局指标包括HS医师全球评估（HS-PGA），Hurley分期，炎性病变计数，瘘管计数和疼痛数字评分量表。

结果

平均而言，在7.1个月的随访期内，受试者每天暴露于75 mg螺内酯。患者在疼痛（Δ-1.5[ P  = .01]），炎性病变（Δ-1.3[ P  = .02]）和HS-PGA评分（Δ-0.6[ P  <.001] ）方面取得了显着的疾病改善。）。不出所料，Hurley分期（Δ0[ P  = .32]）或瘘管（Δ0[ P  = .73]）没有发现变化。每天接受少于75毫克螺内酯的受试者（n = 25；平均剂量，45毫克/天）与每天接受超过100毫克的受试者（n = 21；平均剂量，112毫克/天）之间没有改善。 d）。

局限性

回顾性，有限的样本量以及记录的严重程度变化是限制因素。

结论

用螺内酯治疗HS可减少病灶数，HS-PGA评分和疼痛。低剂量似乎是有效的，并可能对患者的耐受性的担忧相应的选项。