Early advanced therapy in hidradenitis suppurativa may prevent progression to sinus tunnels, scarring, and tissue destruction.

Treating before sinus tunnels become inflamed may reduce the extent and morbidity of later surgery.

Fatigue and speed of response are outcomes important to patients that pivotal trials often fail to capture.

 may limit disease progression, tissue destruction, and the morbidity of later surgery, according to Iltefat Hamzavi, MD, senior staff physician in the Department of Dermatology at Henry Ford Health in Detroit, Michigan. In an interview with 

, Hamzavi outlined outcomes clinicians should weigh beyond those captured in pivotal trials.

Why Early Advanced Therapy Matters in Hidradenitis Suppurativa

Hamzavi presented “Why Early Advanced Treatment Is So Important: Looking Beyond the Pivotal Trials and Primary Endpoint” on October 10 at the 

2026 Fall Clinical Dermatology Conference

 in Las Vegas, Nevada.¹ Gary Goldenberg, MD, chaired the session, which also featured Natasha Atanaskova Mesinkovska, MD, PhD, and Alexandra K. Golant, MD.

Hamzavi described how HS progresses from painful nodules to sinus tunnels with chronic drainage and significant tissue destruction. Early treatment aims to halt this progression, prevent scarring and tunnel formation, and reduce days lost to pain and inflammation. He also pointed to the psychosocial toll of missed life events, such as family milestones and job opportunities, as a key outcome to address.

He cited research from Henry Ford and other centers suggesting the inflammatory infiltrate changes once sinus tunnels become inflamed, which can increase the extent and morbidity of surgery. Treating earlier may reduce this surgical burden.

According to Hamzavi, several outcomes important to patients remain underrepresented in clinical trials. Fatigue is a substantial issue for patients with HS. Speed of response also matters greatly to those living with severe pain.

“If you have a hot poker going into your groin, we would like to have that stop as soon as possible. And to go to your dermatologist and say, ‘Well, it is going to take you 3 months.’ That is not good enough,” Hamzavi said.

Hamzavi noted biologics work in about 60% of patients with HS, even in the best circumstances. Open clinical questions include choosing the right advanced therapy at the right time and deciding when to add other treatments.

Editor’s note: This summary has been edited for grammar and clarity using artificial intelligence tools. Hamzavi is a consultant for AbbVie, Pfizer, Incyte, UCB, Boehringer Ingelheim, Sonoma, Merck, Takeda,Teva, Novartis, Jansen, Avita, Galderma, Vimela, and Almirall; an investigator for Pfizer, Incyte, Avita, L'Oréal/La Roche-Posay, ITN, and AbbVie; and a board member and past president of the Hidradenitis Suppurativa and Global Vitiligo foundations.

Goldenberg G, Mesinkovska NA, Golant AK, Hamzavi I. Why early advanced treatment is so important: looking beyond the pivotal trials and primary endpoint. Presented at: 2026 Fall Clinical Dermatology Conference; October 8-11, 2026; Las Vegas, NV.

Videos

In this interview, Iltefat Hamzavi, MD, explains why early advanced therapy in hidradenitis suppurativa matters beyond pivotal trial primary endpoints.

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Hidradenitis Suppurativa condition center page, audiences can find a variety of coverage mediums for medical news and updates, including articles, video interviews, podcasts, and breaking news on dermatology research, treatment, and drug development.

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Ryan Livingston joined the MJH Life Sciences team in March of 2025, shortly after graduating from TCNJ with a bachelor’s degree in English. He enjoys creative writing, reading, and scuba diving. He can be reached at rlivingston@mjhlifesciences.com.

Hareem Saleem, MBBS | Image Credit: LinkedIn

A new study comparing 3 mineralocorticoid receptor antagonists (MRAs) across the 

 spectrum has demonstrated finerenone’s comparative efficacy in HF with preserved ejection fraction (HFpEF) and mildly reduced ejection fraction (HFmrEF).

Heart Failure Society of America (HFSA) Annual Scientific Meeting 2026

 in Phoenix, Arizona, by Hareem Saleem, MBBS, an internal medicine resident at Memorial Healthcare System Pembroke. The study was undertaken in response to the limited and inconsistent evidence of steroidal agents in HFpEF and HFmrEF.

“Finerenone, a novel nonsteroidal MRA, has recently demonstrated significant reduction in heart failure events and cardiovascular death in patients with HFmrEF and HFpEF, addressing a critical therapeutic gap,” Saleem and colleagues wrote. “We performed a network meta-analysis to compare the efficacy and safety of finerenone with steroidal MRAs.”

Saleem and colleagues conducted a PRISMA-guided network meta-analysis, identifying 1066 individual records. The team selected spironolactone and eplerenone as their comparators to finerenone. A total of 6 comparative studies were ultimately included after screening and eligibility assessment, and data extraction and quality appraisal were independently conducted by 2 reviewers. R software was then used to perform the meta-analysis and generate pooled and comparative effect estimates.

Ultimately, the network meta-analysis scanned 3 randomized trials, encompassing 7 treatment arms and 17 pairwise comparisons. Saleem and colleagues saw no significant differences between finerenone and eplerenone for acute kidney injury (AKI) in random-effects models. However, lower doses of finerenone, namely 7.5-15 mg and 10-20 mg, showed a trend toward reduced AKI risk versus eplerenone (risk ratio [RR], 0.69 and 0.66, respectively). Spironolactone was associated with a greater risk of AKI compared to eplerenone (RR, 1.34) without statistical significance.

Finerenone 15-20 mg was associated with a greater AKI risk reduction than spironolactone in common-effects analysis (RR, 0.83; 95% CI, 0.69-0.98). However, this was not maintained in random-effects models. The team recorded moderate heterogeneity with no significant inconsistency between direct and indirect estimates.

Ranking analysis favored low-to-moderate doses of finerenone regarding renal safety – in contrast, spironolactone ranked the lowest of the 3 treatments. Similar trends were recorded for renal worsening and hyperkalemia outcomes, with finerenone demonstrating a superior safety profile compared with spironolactone and non-significant differences versus eplerenone.

Ultimately, the team concluded that finerenone displays substantially greater efficacy in patients with HFpEF and HFmrEF compared to other MRAs, particularly in regard to renal outcomes. However, Saleem and colleagues also noted the need for more direct clinical comparison to validate these results and determine the ideal MRA for each presentation.

“Finerenone represents an important advancement in the management of HFpEF and HFmrEF, demonstrating improved heart failure outcomes compared with traditional steroidal MRAs, with a favorable safety profile,” Saleem and colleagues wrote. “These findings support its emerging role within guideline-directed therapy and underscore the need for head-to-head trials to define optimal MRA selection across the HF spectrum.”

Saleem H, Hafeez A, Raja A, et al. Comparative Effectiveness of Finerenone, Spironolactone, and Eplerenone Across Heart Failure Spectrum: A Network Meta-analysis. Abstract presented at the Heart Failure Society of America (HFSA) Annual Scientific Meeting 2026, Phoenix, AZ. October 9-12, 2026.

Habib E, Ibrahim R, Pham HN, Abdelnabi M, Kanaan C, Eldeib A, Augusto SN Jr, Ayoub C, Tang WHW, Arsanjani R. Finerenone Versus Spironolactone for Heart Failure with Preserved Ejection Fraction. Cardiovasc Drugs Ther. 2026 Aug;40(4):1419-1422. 

Articles

A recent network meta-analysis presented at HFSA 2026 displays finerenone’s favorable safety profile and comparatively greater reduction of acute kidney injury risk.

Cardiology

Cardiology condition center page is a comprehensive resource for clinical news and insights on cardiovascular and cardiometabolic diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for heart disease and cardiovascular events, as well as associated diabetes, renal failure, and more...

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The HCPLive heart failure page is a resource for medical news and expert insights on HF. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for heart disease, reduced and preserved ejection fraction, and more.

Finerenone Outperforms Spironolactone, Eplerenone in HFpEF, HFmrEF Renal Outcomes

Waiting-room questionnaires let clinicians quickly assess drainage, pain, flares, and quality-of-life effects in hidradenitis suppurativa.

Anticipating patient needs, including flares and comorbidity screening, builds trust in a population with high rates of depression and suicide risk.

Wound care education and procedures such as deroofing work alongside systemic therapy to control persistent localized disease.

 extends beyond medication selection. It also takes structured symptom assessment, comorbidity screening, wound care, and procedures, according to Iltefat Hamzavi, MD, senior staff physician in the Department of Dermatology at Henry Ford Health in Detroit, Michigan. Hamzavi outlined this approach in an interview with 

 in Las Vegas, Nevada, Hamzavi and Jennifer Hsiao, MD, of the University of Southern California, copresented “Beyond Selection of Medications: Managing Patient Expectations and Comorbidities in Hidradenitis Suppurativa.” The session drew on their experience running large multidisciplinary HS clinics at both institutions. Henry Ford’s program includes several dedicated faculty members, surgical partners, and a basic science team funded by the National Institutes of Health.

Hidradenitis Suppurativa Care: Expectations, Comorbidities, and Wound Care

Hamzavi recommended using time in the waiting room to collect patient-reported data before the visit. Questionnaires can capture how often drainage occurs and whether it has an odor, days of pain, missed work, and effects on intimacy and socialization, so clinicians can assess health status quickly. Because HS presents episodically, he also advised counting flare days and giving patients a written plan for managing flares.

“You build rapport with patients by knowing what they are going to deal with, and if you anticipate their next step, it builds that trust because HS is a disease with one of the highest rates of suicide in dermatology. Depression is very high,” Hamzavi said.

Comorbidity screening is part of this anticipatory approach. Hamzavi described giving patients a handout for their primary care physician. It outlines screening for type 2 diabetes, hyperlipidemia, cardiovascular risk, mental and behavioral health concerns, arthritis, and inflammatory bowel disease.

The session also covered how to incorporate newer therapies, how to manage their cutaneous adverse effects, and when to use dual therapy for refractory disease. Hamzavi called wound care a gap in dermatology training. At Henry Ford, a dedicated wound care nurse teaches patients to choose super-absorbent, odor-reducing dressings and tape gentle enough to avoid skin damage.

Procedures remain an important addition to medical therapy. Laser hair removal, local excision, and deroofing can resolve persistent draining tunnels in areas such as the axilla or groin while systemic therapy controls disease elsewhere. Medication can then focus on preventing new lesions.

Hamzavi I, Hsiao J. Beyond selection of medications: managing patient expectations and comorbidities in hidradenitis suppurativa. Presented at: 2026 Fall Clinical Dermatology Conference; October 8-11, 2026; Las Vegas, NV.

Iltefat Hamzavi, MD, outlines how symptom questionnaires, comorbidity screening, wound care, and procedures shape hidradenitis suppurativa care.

Tim Smith joined the MJH Life Sciences team in 2022 and is currently an associate editor for 

. He is also the executive producer of two podcasts: 

. Previously, he was the producer of the Lungcast podcast. He graduated from UC Berkeley and worked in multimedia journalism as a staff writer prior to joining MJH. You can contact him at tsmith@mjhlifesciences.com.

 in Las Vegas brought new long-term data in psoriasis and atopic dermatitis, alongside practical guidance from expert sessions on hidradenitis suppurativa (HS), vitiligo, and skincare. The 

 team has been on-site covering the meeting, which runs from October 8 to 11, 2026.

The following recap highlights several key stories from 

ICONIC-LEAD: Icotrokinra Sustains Psoriasis Skin Clearance at 2 Years

New 2-year data from the phase 3 ICONIC-LEAD study showed the oral IL-23 receptor-targeting peptide icotrokinra maintained high rates of skin clearance in adults and adolescents with moderate-to-severe plaque psoriasis. From Week 64 through Week 112, at least 72% of patients achieved PASI 90 and at least 70% achieved clear or almost clear skin. Among Week 24 PASI 90 responders withdrawn from treatment, 85% regained response within 24 weeks of retreatment.

Ixekizumab, Tirzepatide Broaden Biomarker Effects in Psoriasis, Obesity

Exploratory data from the phase 3b TOGETHER-PsO trial suggested an immunometabolic relationship between psoriasis and obesity. Concomitant ixekizumab and tirzepatide changed 482 proteins and 467 genes by Week 36, compared with 140 proteins and 16 genes with ixekizumab alone. Changes in neutrophil-associated markers mediated part of the additional skin clearance seen with combination therapy.

What Long-Term Data Emerged in Atopic Dermatitis?

Nemolizumab Sustains Atopic Dermatitis Skin, Itch Control Through 3 Years

A post hoc analysis of the ARCADIA long-term extension study found most early responders to nemolizumab maintained deep responses through Week 152. At that timepoint, 80% of patients achieved EASI-90, 50% achieved complete skin clearance, and 80% were itch-free or nearly itch-free. Separate OLYMPIA long-term extension data also showed sustained itch, pain, and sleep improvements in prurigo nodularis.

What Did Experts Share on HS, Vitiligo, and Skincare?

Optimizing HS Biologics, Combinations, and Surgery

Andrea Murina, MD, reviewed strategies for what comes after biologic selection in HS. She highlighted claims data showing 6 in 10 patients stop adalimumab within 1 year, and she encouraged dose optimization and add-on therapies before switching agents. Murina also noted more effective biologics may reduce the need for surgery in some patients with severe disease, and she stressed systemic therapy should not be stopped around procedures.

Topical vs Oral JAK Inhibitors in Vitiligo, With Iltefat Hamzavi, MD

, Iltefat Hamzavi, MD, of Henry Ford Health, explained how he chooses between topical and oral Janus kinase (JAK) inhibitors in vitiligo. He described topical ruxolitinib as suited to localized, stable disease, with oral agents favored for more extensive or unstable disease. Hamzavi also outlined 3 exam findings signaling instability and the cardiovascular risk factors warranting caution with oral therapy.

A Framework for Evaluating Skincare Products

Cheri Frey, MD, offered a framework for evaluating cosmeceuticals, noting terms such as “clean” and “medical grade” correspond to no US Food and Drug Administration (FDA) category. Using an evidence pyramid, she stressed asking whether biomarker improvements translate into clinically meaningful results. Contrasting pigmentation examples illustrated the point: thiamidol produced meaningful improvement in moderate-to-severe melasma, while an exosome-derived product with strong in vitro data showed no clinically apparent brightening, likely because of poor penetration.

 for continued coverage from the remainder of the meeting.

Catch up on HCPLive’s first-half Fall Clinical 2026 coverage, including new psoriasis and atopic dermatitis data and expert insights on HS and vitiligo.

Plaque Psoriasis

The HCPLive plaque psoriasis page is a resource for medical news and expert insights on psoriasis. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for psoriatic disease, and more.

Atopic Dermatitis

Atopic Dermatitis condition center page, audiences can find a variety of coverage mediums for medical news and updates, including articles, video interviews, podcasts, and breaking news on dermatitis research, treatment, and drug development.

Fall Clinical 2026 First Half Recap: Psoriasis, Atopic Dermatitis, and More

A new analysis of the phase 3 ATTRibute-CM study has highlighted an association between cardiovascular-related hospitalization (CVH) and increased risk of all-cause mortality (ACM) in patients with 

transthyretin amyloid cardiomyopathy (ATTR-CM)

 in Phoenix, Arizona, by Quan Bui, MD, assistant professor of medicine in advanced 

 and transplant cardiology at University of California San Diego Health.

“CVH, a known predictor of mortality in patients with general heart failure, is not well characterized in ATTR-CM,” Bui and colleagues wrote. “The relationship between CVH burden and survival has not been fully evaluated.”

ATTRibute-CM was a phase 3, double-blind trial evaluating the efficacy of acoramidis, a high-affinity transthyretin (TTR) stabilizer, in patients with ATTR-CM. Patients were eligible for inclusion if they were between the ages of 18 and 90 years, had an established diagnosis of ATTR-CM, and had clinical heart failure with ≥1 previous hospitalization, among other criteria. Patients with acute coronary syndrome, coronary revascularization, or stroke within 90 days before screening were excluded, among other criteria.

Eligible patients were randomly assigned in a 2:1 ratio to either acoramidis hydrochloride 800 mg or matching placebo twice daily for 30 months. The primary outcome was a 4-step hierarchical analysis including death from any cause, cumulative frequency of CVH, change from baseline in NT-proBNP levels, and change from baseline in 6-minute walk distance. Key secondary outcomes included change from baseline in 6-minute walk distance and Kansas City Cardiomyopathy Questionnaire—Overall Summary (KCCQ-OS) score, among others.

A total of 632 patients were ultimately enrolled in the trial – of these, 421 received acoramidis and 211 received placebo. 21 patients with stage 4 kidney disease (12 from the treatment arm and 9 from placebo) were excluded from the primary analysis. Of the remaining 611, investigators saw that the primary analysis favored acoramidis (

 <.001), with a corresponding win ratio of 1.8 (95% CI, 1.4-2.2). 63.7% of pairwise comparisons favored acoramidis, while 35.9% favored placebo.

In the present analysis, Bui and colleagues created a modified intention-to-treat population including all patients with baseline estimated glomerular filtration rates ≥30 mL/min/1.73m

. In particular, they evaluated patients who experienced 0, 1, and ≥2 CVH events during the study, which were defined as nonelective admissions to acute care settings for cardiovascular-related morbidity or an urgent heart failure visit.

Of the 611 total patients, 416 exhibited no CVH events, 117 had 1 CVH event, and 78 had ≥2 CVH events. Patients with 0, 1, and ≥2 CVH events differed by baseline NT-proBNP (median, 2046, 2473, and 2881 pg/mL, respectively) and variant ATTR-CM (7.5, 12, and 17.9%, respectively).

Bui and colleagues noted that survival decreased progressively with increasing CVH burden during the study’s 30-month follow-up period, and ACM risk substantially rose with an increasing number of CVH events. Survival probability was ultimately 86.7% in patients with 0 CVH events (95% CI, 82.9-89.7%), 68.4% in patients with 1 CVH event (95% CI, 59.1-76%), and 47.7% in patients with ≥2 CVH events (95% CI, 35.9-58.6%). The team concluded that this demonstrated an incremental increase in mortality risk across levels of CVH burden.

“In ATTRibute-CM, a higher burden of CVH events was associated with a significantly higher subsequent risk of ACM over 30 months,” Bui and colleagues wrote. “The association between CVH reduction with effective therapies and improved survival warrants further study.”

Bui Q, Soman P, Emdin M, et al. Association Between the Burden of Cardiovascular-related Hospitalizations and All-Cause Mortality in Transthyretin Amyloid Cardiomyopathy: Insights from ATTRibute-CM. Presented at the Heart Failure Society of America (HFSA) Annual Scientific Meeting 2026, Phoenix, AZ. October 9-12, 2026.

Gillmore JD, Judge DP, Cappelli F, et al. Efficacy and safety of ACORAMIDIS in transthyretin amyloid cardiomyopathy. 

A new analysis of the phase 3 ATTRibute-CM study, presented at HFSA 2026, may indicate a connection between the number of hospitalizations and mortality risk.

Cardiomyopathy

Cardiovascular Hospitalization Associated With Increased Mortality Risk in ATTR-CM

New ARCADIA and OLYMPIA LTE data show nemolizumab sustained skin clearance and itch relief for up to 3 years in atopic dermatitis and prurigo nodularis.

Dermatology

The HCPLive dermatology page is a resource for medical news and expert insights on skin disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for dermatologic conditions, and more.

Two-year ICONIC-LEAD data show oral icotrokinra sustained PASI 90 and IGA 0/1 responses in more than 70% of adults and adolescents with plaque psoriasis.

New TOGETHER-PsO data show ixekizumab plus tirzepatide drove broader immune and metabolic biomarker changes than ixekizumab alone in psoriasis and obesity.

Both doses of the anti-ILT7 antibody daxdilimab reduced CLASI-A scores vs placebo at week 24 in moderate-to-severe, treatment-refractory discoid lupus.

Daxdilimab Improves Discoid Lupus in Phase 2, With Victoria Werth, MD

Iltefat Hamzavi, MD, explains how topical and oral JAK inhibitors fit into vitiligo care and which patients are the best candidates for each approach.

Vitiligo

Vitiligo condition center page is a comprehensive resource for clinical news and insights on the dermatologic condition. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for the affected skin of vitiligo patients.

Nancy Reau, MD, is Professor of Internal Medicine, Richard B. Capps Chair of Hepatology, Associate Director of Solid Organ Transplantation, and Section Chief of Hepatology at Rush University Medical Center.

Podcasts

Jasmohan Bajaj, MD, joins Nancy Reau, MD, and Kim Brown, MD, to review what is new in the ACG hepatic encephalopathy guideline.

Hepatology

podcasts page features a feed of medical news and interview podcast series, including DocTalk, Lungcast, Derm Discussions, and Heart Trials.

Liver Lineup: Updates & Unfiltered Insights

Introducing Liver Lineup: Updates & Unfiltered Insights — an exciting new podcast delivering timely, candid perspectives on the most pressing topics in the fast-moving world of hepatology. Hosted by Nancy Reau, MD, and Kimberly Brown, MD, this series dives into the cutting edge of liver disease research, clinical care, and real-world practice.

Liver Lineup: What's New in the ACG Hepatic Encephalopathy Guideline

Aaron Mangold, MD, discusses phase 2 BEACON data on brepocitinib, a TYK2/JAK1 inhibitor, in cutaneous sarcoidosis presented at EADV 2026.

Brepocitinib Improves Cutaneous Sarcoidosis by Week 4: Aaron Mangold, MD

Kunihiro Hattori, PhD, is a mentor with the Japan International Drug Discovery Ecosystem Association. He spent 40 years at Chugai Pharmaceutical. He joined in 1984 and went on to lead the Genome and Antibody Research Department and later the Discovery Research Department. He then served as a fellow and as associate vice president and senior fellow until 2024. From 2017 to 2024, he was also a visiting professor at the Immunology Frontier Research Center at Osaka University. Hattori originated the concept of a bispecific antibody to replace the function of factor VIII and led the research project that produced emicizumab. He earned his PhD from the Graduate School of Pharmaceutical Sciences at Osaka University.

Lasker Award winners Takehisa Kitazawa and Tomoyuki Igawa discuss prophylaxis gains, remaining unmet needs, and lessons for drug discovery.


Hematology

How Emicizumab Changed Hemophilia A Prophylaxis, and What Comes Next

Chelsie Derman is an associate editor for 

who covers allergy and  psychiatry. She joined MJH Life Sciences in September 2023 after graduating from The College of New Jersey with a bachelor’s degree in journalism and professional writing. In her free time, she enjoys creative writing and reading.

In the phase 3 RAPIDe-3 trial published in The Lancet, median time to symptom relief was 1.28 hours with deucrictibant vs more than 12 hours with placebo.

Allergy

Allergy condition center page is a comprehensive resource for clinical news and insights on allergic and inflammatory diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for food and seasonal allergies, as well as allergic asthma and related conditions.

Oral Deucrictibant Speeds Relief of Hereditary Angioedema Attacks

Lasker Award winners Kunihiro Hattori, Takehisa Kitazawa, and Tomoyuki Igawa recount the 2400 variants behind the drug.

Latest News

Why Early Advanced Therapy Matters in Hidradenitis Suppurativa

Finerenone Outperforms Spironolactone, Eplerenone in HFpEF, HFmrEF Renal Outcomes

Hidradenitis Suppurativa Care: Expectations, Comorbidities, and Wound Care

Fall Clinical 2026 First Half Recap: Psoriasis, Atopic Dermatitis, and More

Cardiovascular Hospitalization Associated With Increased Mortality Risk in ATTR-CM