Familial hidradenitis suppurativa associated with higher risk for metabolic disease 

A recent meta-analysis highlighted that familial cases of hidradenitis suppurativa (HS) are associated with a significantly increased risk of cardiovascular diseases, hyperlipidaemia, and diabetes mellitus. This finding could alter the approach to managing HS for patients with a family history of the disease.

In general, there is a higher risk of metabolic and cardiovascular diseases in TNF-α/IL-17-driven diseases like psoriasis, which are known to be linked to cardiovascular comorbidities. Thus, Dr Suzan Al-Gburi (University Hospital Cologne, Germany) and colleagues were interested in the role of a positive family history in patients with HS regarding these comorbidities [1].

They performed a meta-analysis of 2 German studies, the EpiCAi and the BATMAN studies, including 236 participants with HS. Among these, 25.8% had a positive family history of HS, while the rest were sporadic cases. “Interestingly, age of onset was significantly earlier in cases with familial predisposition, while the diagnosis was made markedly later [about 4 years],” Dr Al-Gburi said.

Despite familial cases demonstrating slightly less severe disease activity, the risk for metabolic disease was profoundly higher in these patients. Specifically, the odds ratios for hyperlipidaemia, cardiovascular diseases, and diabetes mellitus were 2.36, 2.99, and 1.76, respectively, when compared with participants with sporadic HS​. “Having at least one of the diseases mentioned above had an odds ratio of 2.27. This implies that there is a more than doubled risk of patients with a positive family history suffering from metabolic disease,” Dr Al-Gburi said. Notably, these increased risks were independent of common risk factors such as smoking and body mass index, suggesting an inherent link between familial HS and metabolic syndrome.

The study underscored the need for specialised cardiovascular monitoring and earlier intervention in patients with familial HS. Earlier diagnosis and tailored management, particularly for cardiovascular and metabolic comorbidities, could significantly improve long-term outcomes for this patient population.

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   1. Al-Gburi S, et al. Familial occurrence of hidradenitis suppurativa is associated with increased risk of metabolic syndrome. Abstract 7997, EADV Congress 2024, 25–28 September, Amsterdam, the Netherlands.

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Medical writing support was provided by Dr Susanne Kammerer



Posted on 2 October 20242 October 2024