Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition associated with severe symptom burden, high psychiatric comorbidity, and profound impairment in health-related quality of life (HRQoL). Despite the disease burden, no systematic synthesis has characterized the palliative and supportive care needs of this population. This review aimed to synthesize evidence on the palliative and supportive care needs of adults with advanced HS, to evaluate validated patient-reported outcome measures applicable to this domain, and to characterize unmet needs and barriers to care. This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and registered on the International Prospective Register of Systematic Reviews (PROSPERO). Studies reporting palliative care-relevant outcomes in adults with HS were included. Quality was appraised using Joanna Briggs Institute (JBI) Prevalence Checklists, Newcastle-Ottawa Scale, and Critical Appraisal Skills Programme (CASP) tools. Seven studies (sample sizes ranging from 77 to 1,787; conducted across 27 countries; published between 2020 and 2025) were included. Across included studies, 61.4% (n = 798/1,299) of the patients experienced moderate-to-severe pain, while drainage and fatigue were reported by 71.8% (n = 933/1,299) and 61.0% (n = 793/1,299), respectively. Depression was present in 30.3-35.8% of participants (from 154/508 to 465/1,299) and anxiety in 36.2-57.5% (from 470/1,299 to 292/508); suicidal ideation was reported by 7.9% (n = 103/1,299) and suicidal attempt by 4.2% (n = 55/1,299). Sexual dysfunction affected 60.8% (n = 45/74), and hindered sexuality affected 61.8% (n = 47/76). Only 4.5% (n = 24/529) of adults achieved complete disease control despite active dermatologist treatment. Emotional burden consistently exceeded physical symptom burden. Caregiver needs, spiritual concerns, and advance care planning remain unstudied. Adults with advanced HS carry a multidimensional, unmet palliative and supportive care burden, underscoring the importance of integration of psychological screening, sexual health assessment, and pain management protocols.

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory dermatosis with limited treatment options. This systematic review and meta-analysis aimed to evaluate the evidence regarding the use of bimekizumab for treating moderate-to-severe HS, focusing on its clinical efficacy, safety, and outcomes across different clinical parameters. Methods: We followed the “preferred reporting items for systematic reviews and meta-analyses” (PRISMA) guidelines and performed a systematic search for trials that compared bimekizumab with a placebo in patients with moderate-to-severe HS. A comprehensive search of PubMed, Web of Science, Cochrane CENTRAL, and Embase was conducted up to April 2025. The primary outcome of efficacy was the percentage of patients who reached “HS Clinical Response 50” (HiSCR50), with secondary outcomes including HiSCR75, reduction in skin pain, and safety (evaluated by serious adverse events). Two reviewers independently assessed the risk of bias using the Cochrane risk-of-bias 2 tool. A fixed-effects model was used for meta-analysis. The study protocol was preregistered in PROSPERO (CRD420251025763). Results: Three RCTs, encompassing 1218 participants, were included. Bimekizumab made it substantially more probable that the HiSCR50 would be reached (RR: 1.64; 95% CI [1.37–1.97]; P <.00001) than the placebo. Patients who received bimekizumab were also substantially more likely to achieve higher response levels, HiSCR75 (RR: 1.98; 95% CI [1.52–2.59]; P <.00001) and a considerable reduction in skin pain (RR: 2.29; 95% CI [1.54–3.42]; P <.0001). For all measures of efficacy, both the every-two-week and every-four-week dosage schedules were better than the placebo. The occurrence of serious adverse events did not differ significantly between the bimekizumab and placebo groups (RR: 2.34; 95% CI [0.80–6.79]; P = .12). Conclusion: The evidence, although derived from a limited number of trials, demonstrates the superiority of bimekizumab over placebo. For patients with moderate-to-severe HS, bimekizumab showed significantly improved outcomes compared to placebo in terms of enhancing clinical response and lessening skin pain. Although no statistically significant increase in serious adverse events was observed, a potential risk cannot be definitively ruled out given the numerical imbalance.