Cortexolone 17α‐propionate for hidradenitis suppurativa

@article{DerSarkissian2020Cortexolone1F,
  title={Cortexolone 17$\alpha$‐propionate for hidradenitis suppurativa},
  author={Samuel Antranig Der Sarkissian and Helen Yiling Sun and Deshan Frank Sebaratnam},
  journal={Dermatologic Therapy},
  year={2020},
  volume={33}
}
Dear Editor, We read Herbert et al's article describing the efficacy of topical clascoterone (cortexolone 17α-propionate) cream in treating acne with a keen interest into its potential applications in other dermatological diseases. Whilst different pathological entities, hidradenitis suppurativa (HS) and acne share similar underlying biological processes; specifically, adnexal occlusion associated with the promotion of pro-inflammatory cytokines. Evidence regarding the role androgens play in… 

References

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The Role of Androgens and Estrogens in Hidradenitis Suppurativa - A Systematic Review.
TLDR
The results show that patients with HS do not seem to have increased levels of sex hormones and that their hormone levels lie within the normal range, and antiandrogen treatment could be a valuable approach in treating HS, however randomized control trials are lacking.
Is There a Role for Antiandrogen Therapy for Hidradenitis Suppurativa? A Systematic Review of Published Data
TLDR
The existing studies do not allow a robust evidence-based recommendation for the use of antiandrogens in the treatment of hidradenitis suppurativa/acne inversa and further randomized controlled trials are needed to define the role of hormonal treatment as an alternative or concomitant therapy together with antibiotics or biologics.
Cortexolone 17α-propionate (Clascoterone) Is a Novel Androgen Receptor Antagonist that Inhibits Production of Lipids and Inflammatory Cytokines from Sebocytes In Vitro
TLDR
Clascoterone was found to bind the androgen receptor (AR) with high affinity in vitro, inhibit AR-regulated transcription in a reporter cell line, and antagonize androgen-regulated lipid and inflammatory cytokine production in a dose-dependent manner in human primary sebocytes.
Part I. Hidradenitis Suppurativa: Epidemiology, clinical presentation, and pathogenesis.
A case series of 20 women with hidradenitis suppurativa treated with spironolactone
TLDR
Spironolactone is advocated as a useful, low‐cost first‐line treatment for women with HS, with relatively few side‐effects, and there is limited literature documenting the use of anti‐androgens in HS.
Efficacy and Safety of Topical Clascoterone Cream, 1%, for Treatment in Patients With Facial Acne
TLDR
Results of 2 phase 3 randomized clinical trials demonstrated that patients with acne treated with clascoterone cream experienced greater treatment success vs treatment with vehicle, with considerable reductions in absolute noninflammatory and inflammatory lesion counts.
Hidradenitis suppurativa