HIDRAscore Measures Severity of HS, Includes Patient Reports

A novel scoring system for hidradenitis suppurativa severity that includes a patient-reported component has been developed.

A novel scoring metric for hidradenitis suppurativa (HS), the HIDRAscore, that can be used as an accompaniment to clinical evaluation and includes a patient-reported outcome metric called HIDRAdisk, according study research published in the Journal of the European Academy of Dermatology and Venereology. 

The retrospective analysis included data from 308 patients (mean age, 35.2 years) with HS who participated in the multicenter HIDRAdisk study, which examined quality of life in  patients with HS for at least 6 months prior to study participation. The Hurley stage and HS Physician’s Global Assessment scale were used to assess disease severity, and the HS Clinical Response was used to define disease improvement at 3-month and 9-month visits. One question from the Subject Satisfaction Questionnaire was used as a gold-standard basis for the new patient-evaluated HS severity score: “When compared with your total experience with HS, how would you describe the severity of your condition today?” Multivariable logistic regression was used to evaluate the association of clinical variables and HIDRAdisk score with the gold-standard question. The final models’ discriminant power was assessed using the Hosmer-Lemeshow test for goodness-of-fit and the area under the receiver operating characteristic curve.

In the study population, 94.5% of patients (n=291) completed the 3-month visit, and 82.1% of patients (n=253) completed the 9-month visit. Numbers of inflammatory nodules, draining fistulas, and abscesses, as well as HIDRAdisk score and presence of subumbilical lesions, were significantly associated with the Subject Satisfaction Questionnaire gold-standard question. The HIDRAscore is the sum of the scores associated with these different categories, and ranges from 0 to 10, with increasing scores indicating increased severity. According to the researchers, the HIDRAscore’s predictive capability was very good, with a Hosmer-Lemeshow test P =.303 and the area under the receiver operating characteristic curve being 0.88 (95% CI, 0.82-0.93).  

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Although the scoring system needs to be examined for validity in a larger sample of participants to assess generalizability, the study researchers concluded that the “HIDRAscore, in addition to the objective clinical examination, requires the involvement of the patient,” and that patient inclusion in disease evaluation can create better physician-patient communication, better adherence, a sense of control over the disease, satisfaction, and better outcomes. The study researchers added that a validation process in a large real-life cohort of patients is still needed.

Disclosure: This clinical trial was supported by AbbVie Srl. Please see the original reference for a full list of authors’ disclosures.

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Marzano AV, Chiricozzi A, Giovanardi G, et al.  Creation of a severity index for hidradenitis suppurativa that includes a validated quality‐of‐life measure: the HIDRAscore [published online March 2, 2020]. J Eur Acad Dermatol Venereol. doi: 10.1111/jdv.16328