1. How long will it take before I see a response?
3. What happens if I accidentally miss a dose?
4. Biologics for HS are relatively new. How do I know they’re safe?
5. Does taking this medication increase my risk of cancer ?
6. Can I get pregnant while taking this medication?
2. What if I’m scared of needles?
7. Will I need to take this medication forever?
8. What happens if a biologic drug doesn’t work or stops working?
9. Will I have to take these medications forever?
8. Will I be able to afford this medication?
7. JAK inhibitors are still pretty new – are you sure they’re safe?
6. I read that JAK inhibitors increase the risk of blood clots. Should I be worried?
5. Can taking a JAK inhibitor cause cancer?
4. Why do I need to get certain vaccinations first?
3. Will taking a JAK inhibitor shut down my immune system?
2. If one JAK inhibitor doesn’t help me, does that mean none of them will?
1. Which JAK inhibitor is most likely to help me?
FAQs About Biologics for HS, Answered
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ALESHIN: Don’t make any big decisions before the three-month mark, unless you’re having serious side effects, because it does take some time for the medication to start working. Then, at the six-month mark, if there’s absolutely no improvement, we’ll talk about risks and benefits of switching to a different medication.
NAIK: An initial reservation about self-injection is common. There are programs through pharmaceutical companies where a nurse will come and teach you how to self-inject. And once you get over that hurdle, it’s usually smooth sailing.
NAIK: The general guidance is that, for example, if you take a medication weekly and you forget to take it on your scheduled day, but you remember it the next day, it’s completely fine to take it the next day. It’s not something that should happen regularly, but life happens. What we don’t want to see is a more long-term hiatus from biologic medications, because skipping several doses, or regularly stopping and restarting, can contribute to the development of resistance to the medication. So taking your medication on time is a really important part of biologic treatment. Ultimately, you should talk to your doctor if you miss a dose.
ALESHIN: Biologics are a relatively new medication approved to treat HS in the United States, but they’ve been around for quite a long time and are used for treating other skin conditions like psoriasis, as well as other inflammatory conditions like rheumatoid arthritis. So we actually do have very good long-term safety data.
HAMZAVI: There’s a theoretical risk of internal cancers, but that risk is very low. We haven’t seen much actual evidence of that with biologics used to treat HS.
5. Does taking this medication increase my risk of cancer?
ALESHIN: As of recently, there’s been a lot of investigative work around how to manage HS in pregnancy but there’s still not a lot of data out there. It ultimately comes down to discussion between your dermatologist, your ob-gyn, and you.
ALESHIN: What we know with these medications is that some people can have a long-lasting response, but it can lose efficacy over time. Each person is unique and responds to biologic drugs in their own way. So we guide treatment length based on how you’re responding. If it’s going well, we may keep you on it for a prolonged period of time. Sometimes we use biologics to help quiet the inflammatory response and then reassess to see if that person is a good candidate for surgery to excise the lesions, in which case we may possibly take them off the biologic.
HAMZAVI: If you try adalimumab and it doesn’t work, or it loses effectiveness over time, there are other options. We commonly use infliximab in more severe cases that fail to respond to adalimumab. We find it’s an effective option because you can dose at a more frequent level, so we can customize it to the patient. But it does have more side effects.