ConexiantFDA Approves Secukinumab for Adolescents with Moderate to Severe Hidradenitis Suppurativa

The FDA has approved secukinumab (Cosentyx) for adolescents aged 12 and older with moderate to severe hidradenitis suppurativa, making it the only IL-17A inhibitor approved for pediatric HS. The approval addresses a condition affecting up to 1 in 100 people, with more than half experiencing onset during adolescence and diagnosis delays averaging up to 10 years.

Clinical Considerations

• Secukinumab introduces an IL-17A mechanism not seen in HS therapies in nearly a decade, expanding the biologic landscape for adolescent patients
• Pediatric approval was supported by adult HS studies, pharmacokinetic modeling, and pediatric data from other approved indications, not a dedicated adolescent HS trial
• Weight-based dosing for patients at least 30 kg is projected to achieve drug exposure comparable to adults
• HS frequently emerges around puberty; earlier biologic access may help prevent irreversible scarring in adolescent patients

Practice Applications

• Identify adolescent patients with moderate to severe HS who may be candidates for secukinumab
• Review weight-based dosing parameters before prescribing: patients must weigh at least 30 kg
• Counsel families that approval relied on extrapolated adult data, not a dedicated pediatric HS trial
• Screen for comorbid immune-mediated conditions where secukinumab’s broader indications may offer additional benefit

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