A Comprehensive Review of the Efficacy of Tetracyclines in Treating Hidradenitis Suppurativa

Title: A Comprehensive Review of the Efficacy of Tetracyclines in Treating Hidradenitis Suppurativa.

Background: The etiology of hidradenitis suppurativa (HS) is multifactorial. Tetracyclines are a class of antibiotics with anti- inflammatory properties that are commonly used as a first-line treatment for HS. Objective: To comprehensively review the existing literature to analyze various outcomes that measure the response to tetracycline treatment.

Method: The PubMed database was searched for all articles that mentioned tetracyclines and HS. Studies were included if they evaluated the efficacy of tetracycline monotherapy using known quantifiable outcomes such as Dermatology life Quality Index (DLQI), Hidradenitis Suppurativa Clinical Response (HiSCR), International Hidradenitis Suppurativa Severity Score System (IHS4), and Sartorius Hidradenitis Suppurativa Score (HSS). Case reports, reviews, duplicate articles, and studies involving pediatric patients were excluded.

Results: Our search resulted in 83 articles. After screening, five studies were included and assessed for information regarding study design, treatment protocols, and outcomes. The most common outcome used to evaluate tetracycline therapy was the DLQI. Summaries of the studies are shown in Table 1. Statistically significant reductions were seen for all outcomes except for DLQI in Ravn Jørgensen et al. when assessing doxycycline (p=0.273) and IHS4 in Caposiena Caro et al. (p=0.11).

Discussion: These findings highlight the importance of tetracyclines as a first-line treatment and the effectiveness of tetracyclines as a class in treating HS. The development of of newer, third-generation tetracyclines such as omadacycline, tigecycline, and sarecycline warrant new studies to examine the efficacies of these drugs in managing HS.

This project was a collaborative effort with researchers at NYMC. Thank you for allowing me to assist you with this project.