Promising New Treatment for Hidradenitis Suppurativa

Original Article: Efficacy and Safety of the Heat Shock Protein 90 Inhibitor RGRN-305 in Hidradenitis Suppurativa A Parallel-Design Double-Blind Trial

What are the key takeaways of this article?

Hidradenitis suppurativa is a chronic and painful immune-mediated skin condition that affects about 1% of the population and often begins in adolescence. It is characterized by painful nodules, abscesses, and scarring mainly in the axillary, inguinal, inframammary, and anogenital regions. Although its exact pathogenesis is not completely understood, aberrant inflammation involving proinflammatory cytokines and signaling pathways play a key role in this process.

Current treatments for hidradenitis suppurativa are limited and often inadequate, highlighting a need for more effective therapies. In this regard, the heat shock protein 90 (HSP90) inhibitor RGRN-305 has emerged as a promising candidate. This study, conducted at Aarhus University Hospital, Denmark, from September 2021 to August 2022, was a parallel-design, double-blind, placebo-controlled trial aiming to evaluate the efficacy and safety of RGRN-305 in treating moderate to severe hidradenitis suppurativa.

The trial involved 15 patients (67% female, median age 29 years), randomly assigned to receive either RGRN-305 or a placebo for 16 weeks. The primary efficacy endpoint was the percentage of patients achieving a 50% reduction in lesion count (HiSCR-50) by week 16. Secondary endpoints included higher levels of HiSCR, physician's global assessment, quality of life scores, and pain rating.

The results were promising. In the RGRN-305 group, 60% achieved HiSCR-50, compared to only 20% in the placebo group. Furthermore, 50% and 30% of the RGRN-305 group achieved HiSCR-75 and HiSCR-90, respectively. These levels were not reached by any patient in the placebo group. RGRN-305 also showed rapid action in reducing abscesses and tunnels, with significant improvement in inflammatory nodules after 10 weeks. Moreover, patients on RGRN-305 reported greater improvements in quality of life and pain reduction. In terms of safety, RGRN-305 was well-tolerated, with mild to moderate treatment-emergent adverse events similar in frequency to the placebo group. No serious adverse events or deaths were reported.

In summary, this study's findings may be quite influential as they suggest that inhibiting heat shock protein 90 with RGRN-305 could offer a new and effective mechanism for treating hidradenitis suppurativa. The outcomes indicate that RGRN-305 is not only efficient in reducing skin lesions and improving patients' quality of life but also safe for consumption, marking it as a potential novel tool in dermatological therapeutics. However, the limitations of a small sample size and most of the participants being White may impact the generalizability of the results.

Publication Date: February 19th, 2024

Reference: Ben Abdallah H, Bregnhøj A, Emmanuel T, Ghatnekar G, Johansen C, Iversen L. Efficacy and Safety of the Heat Shock Protein 90 Inhibitor RGRN-305 in Hidradenitis Suppurativa: A Parallel-Design Double-Blind Trial. JAMA Dermatol. 2024;160(1):63–70. doi:10.1001/jamadermatol.2023.4800

Summary By: Parsa Abdi