Povorcitinib: A Promising Oral Treatment for Tough Hidradenitis Suppurativa Cases
New oral medicine for hidradenitis suppurativa: what patients should know
If you have hidradenitis suppurativa (HS) or are following treatment news, you may have heard about a new pill being tested called povorcitinib. HS is a long-term skin condition that causes painful lumps, tunnels under the skin, drainage, and scarring, often in places like the armpits, groin, or under the breasts.
Phase 3 trial results for povorcitinib are still emerging, but experts involved in the research say the drug could fill some important gaps in HS care—especially for people whose disease hasn’t improved on current treatments or for those who do not want injectable medications. These observations come from an interview and presentations discussing the STOP-HS phase 3 program (Source: STOP-HS program phase 3 data; interview/presentation with Martina Porter, MD, Beth Israel Deaconess Medical Center).
Quick summary
Povorcitinib is an oral medication that targets a protein called JAK1, which is part of the immune system’s inflammation signaling. Early phase 3 data suggest it may help people with HS, including some who didn’t respond to biologic injections. A common side effect in the trials was acne, seen in about one in five participants, but most cases were mild and did not force people to stop treatment (Source: STOP-HS program phase 3 data; interview/presentation with Martina Porter, MD).
What is povorcitinib and how might it help?
Povorcitinib is an oral drug that blocks JAK1. JAK1 is one part of a chain of signals the immune system uses to create inflammation. Because JAK1 affects different inflammatory pathways than drugs that block TNF-alpha or IL-17, researchers think povorcitinib might help people whose HS didn’t improve on those biologic treatments. In the trials, people who had used biologics before were sicker at the start but showed responses similar to those who had never used biologics (Source: STOP-HS program phase 3 data; interview/presentation with Martina Porter, MD).
What the trials found about side effects — acne in particular
A noticeable side effect was acne, reported in just under 20% of participants in the STOP-HS program. Acne rates were similar whether people took 45 mg or 75 mg of the drug, and nearly all cases were mild. A few were moderate, and none were severe enough to make someone stop treatment (Source: STOP-HS program phase 3 data; interview/presentation with Martina Porter, MD).
It’s important to understand the context. Acne and HS often occur together in the same people. In clinical trials, common acne medicines such as oral antibiotics and isotretinoin are usually not allowed because they could affect the trial’s measures of how well HS is responding. That means trial doctors could not treat acne as aggressively as they might in everyday practice. Based on clinical experience with JAK inhibitors for other inflammatory diseases, acne from JAK blockers is often mild, follows a hormonal pattern (for example, on the face and jawline), and can usually be treated with standard acne approaches once the drug is available in routine care (Source: interview/presentation with Martina Porter, MD).
Who might consider this treatment in the future?
Investigators think povorcitinib may be helpful for people who have not improved with current biologic injections, because it works on different inflammatory signals. That means it could become an option for people with treatment-resistant HS and might even be studied later in combination with other therapies for very stubborn cases (Source: STOP-HS program phase 3 data; interview/presentation with Martina Porter, MD).
Another practical benefit is that it’s a pill. Some younger patients are reluctant to start injectable treatments, so an oral option could be more acceptable. An oral drug also tends to have a shorter time in the body than long-acting injections, which can make dosing adjustments easier (Source: interview/presentation with Martina Porter, MD).
Who seemed to respond well in early reports?
Based on clinical observations made by researchers, two groups appeared to respond particularly well to JAK1 inhibition: people with severe HS that forms fistulas and tunnels similar to Crohn’s disease–associated HS, and people with long-standing nodular HS that has little tunneling but often runs in families. These are early observations and may help guide future research into who benefits most (Source: interview/presentation with Martina Porter, MD).
Why timing matters
Experts emphasize the importance of treating HS earlier when possible. Early treatment may prevent irreversible scarring and the development of sinus tracts (tunnel-like channels under the skin). Researchers are hopeful that, as more therapies become available, doctors may be better able to match treatment to each person’s disease pattern and possibly take advantage of a “window of opportunity” before permanent damage occurs (Source: interview/presentation with Martina Porter, MD).
Keeping an eye on skin changes
It can help to track your skin over time by taking photos and noting when bumps appear, get worse, drain, or scar. That information can make clinic visits more productive and help your doctor understand whether a treatment is working.
When to see a doctor
If you have painful, recurring lumps, drainage, persistent scarring, or symptoms that are getting worse, talk with a dermatologist or your healthcare provider. HS can be progressive, and getting evaluated early may expand your treatment choices. Also seek prompt care for signs of infection such as sudden worsening, increased pain, fever, spreading redness, or bleeding.
Important caution
The findings described here come from phase 3 trial data and comments by investigators involved in those studies. That means the information is promising but still emerging. Trials often have rules and conditions that differ from everyday medical practice, and more research is needed to fully understand how well povorcitinib works and how to manage side effects in routine care. This article is informational and not medical advice. Discuss treatment options with a dermatologist or your healthcare provider to find the best plan for you.
Sources
- STOP-HS program phase 3 data; interview and presentations with Martina Porter, MD, Beth Israel Deaconess Medical Center (Source: STOP-HS program phase 3 data; interview/presentation with Martina Porter, MD).