BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory 
skin disease with frequent comorbidities of painand depression. Adalimumab 
treatment for 16 weeks improved HS lesions significantly versus 
placebo (NCT00918255).
OBJECTIVE: The relationship between pain and depressive symptoms and the effects 
of adalimumab on each was examined in this post hoc analysis.
METHODS: Patients with moderate to severe HS (N=154) were randomized 1:1:1 to 
adalimumab 40 mg weekly (ew), adalimumab 40 mg every other week (eow), or 
placebo. Skin pain was assessed using a visual analog scale (VAS; 0-100 mm). 
Depressive symptoms were assessed using the 9-item Patient Health Questionnaire 
(PHQ-9; score ≥10 indicative of depression).
RESULTS: At baseline, overall mean±SD pain VAS was 54.3±26.5 mm and 41.8% of 
patients had PHQ-9 scores ≥10. At baseline, VAS pain scores (mean±SD) were 
significantly higher (P&lt;0.001) for patients with PHQ-9 scores ≥10 (63.9±23.3) 
versus &lt;10 (47.4±26.7). At Week 16, clinically relevant pain reduction was 
observed for ew-treated patients with baseline PHQ-9 score ≥10 (ew, 45.8%; 
eow, 29.4%; placebo, 23.8%) and &lt;10 (ew, 50.0%; eow, 37.9%; placebo, 29.6%), 
but did not reach statistical significance. In patients with high baseline pain 
(≥median VAS score), adalimumab ew significantly decreased depressivesymptoms 
versus placebo (PHQ-9 scores, -34.03% vs +2.26%; P&lt;0.01).
CONCLUSION: Patients with moderate to severe HS had a high degree of pain and 
depressive symptoms at baseline. Adalimumabtherapy was associated with decreased 
pain and depressive symptoms compared to baseline.