Hidradenitis suppurativa (HS) is often managed with antibiotics; however, the evidence-based literature available on their use is limited. Considering that HS is not primarily an infectious disease, the present study evaluated the efficacy of subantimicrobial, modified-release doxycycline (MR-DC) vs regular-release doxycycline (RR-DC) for the treatment of HS.

It randomized the patients to receive treatment with either MR-DC 40 mg once daily or RR-DC 100 mg twice daily for a period of 12 weeks. The study then assessed the treatment efficacy after 12 weeks of treatment using the International Hidradenitis Suppurativa Severity Score System (IHS4), the Dermatology Life Quality Index (DLQI) and the Hidradenitis Suppurativa Clinical Response (HiSCR). 

It observed:

• Enrollment of 49 patients (25 in the MR-DC group and 24 in the RR-DC group).
• A statistically significant reduction of IHS4 and DLQI in both groups at week 12.
• Achievement of HiSCR by 64% of patients receiving MR-DC and 60% of those receiving RR-DC. 

This study shows comparable efficacy of MR-DC to RR-DC in treating HS. MR-DC may be a valuable alternative to other antibiotic regimes, considering its anti-inflammatory properties and lower potential to induce antibiotic resistance.

Source: Kontochristopoulos G, Tsiogka A, Agiasofitou E, et al. Efficacy of subantimicrobial, modified-release doxycycline compared to regular-release doxycycline for the treatment of hidradenitis suppurativa. Skin Appendage Disord. 2022;8:476-81.