Research Briefing — March 2026
New treatments, clinical trials, pipeline drugs, and breakthrough research
The Big Picture
No outright cure exists yet, but the HS treatment landscape has expanded dramatically — from one approved biologic to three, with a deep pipeline spanning at least 6 distinct mechanisms of action. Oral therapies (JAK inhibitors) and even topical creams are in advanced trials.
Three biologics are currently approved for moderate-to-severe HS. All are injectable monoclonal antibodies targeting specific inflammatory pathways.
First biologic approved for HS. Targets tumor necrosis factor alpha. Biosimilar adalimumab-aaty (Yuflyma) approved in 2023/2025.
First IL-17A inhibitor approved for HS. Expanded to adolescents (12+) in March 2026 — the only IL-17A inhibitor for this age group.
Newest approved biologic. Dual inhibition of IL-17A and IL-17F — potentially the most potent biologic per network meta-analysis.
A new comparative study showed bimekizumab demonstrated superior long-term efficacy vs. secukinumab at weeks 48–52:
| Outcome | Odds Ratio (Bimekizumab vs Secukinumab) | 95% CI |
|---|---|---|
| HiSCR 50 | 2.68 | 1.71 – 4.19 |
| HiSCR 75 | 2.20 | 1.48 – 3.26 |
| HiSCR 90 | 2.00 | 1.32 – 3.02 |
| HiSCR 100 | 1.84 | 1.17 – 2.90 |
| Fewer Flares | 0.58 | 0.38 – 0.88 |
Source: Dermatology Advisor
Over 20 drugs are in active development across multiple mechanisms. Several represent entirely new classes for HS — including oral pills and topical creams.
These are pills — a significant shift from injectable biologics. JAK inhibitors block the JAK-STAT signaling pathway that drives multiple inflammatory cytokines simultaneously.
| Drug | Mechanism | Phase | Key Efficacy | Timeline |
|---|---|---|---|---|
| Povorcitinib Incyte |
JAK1 | Phase 3 | HiSCR50: 40–42% vs 29% placebo at 12 weeks | LTE data by Dec 2026 |
| Upadacitinib AbbVie (Rinvoq) |
JAK1 | Phase 3 | Phase 2: 14.7% improvement over placebo; works in TNF-failure patients | Results ~Mar 2028 |
| Ruxolitinib cream Incyte |
JAK1/2 (topical) | Phase 3 | Phase 2: HiSCR50 79.2% vs 50% placebo at 16 weeks (mild-moderate) | Results Jul 2027 |
The topical ruxolitinib result is noteworthy — this could become the first topical prescription for milder HS.
Source: Practical Dermatology
Building on the success of secukinumab and bimekizumab, these target IL-17 with novel molecular formats — nanobodies, small proteins, and bispecific antibodies.
| Drug | Mechanism | Phase | Key Efficacy | Timeline |
|---|---|---|---|---|
| Sonelokimab MoonLake |
IL-17A/F nanobody | Phase 3 | Phase 2b: HiSCR75 43.3% vs 14.7% placebo | Extension Jun 2028; adolescent trial Mar 2027 |
| Izokibep Acelyrin / Affibody |
IL-17A (Affibody) | Phase 3 | HiSCR75: 33% vs 21% placebo at wk 12; 40% at wk 16 | Completed; regulatory TBD |
| Brivekimig — |
IL-17 pathway | Phase 2a | HiSCR50: 67% vs 37% placebo at 16 weeks | Next phase TBD |
| Drug | Mechanism | Phase | Key Efficacy | Timeline |
|---|---|---|---|---|
| Lutikizumab AbbVie |
Dual anti-IL-1α/β | Phase 3 | Phase 2: HiSCR50 59.5% (300mg q2w) vs 35% placebo in TNF-failure patients | Phase 3 results Dec 2026 |
| LAD191 Novartis |
Anti-IL-1RAP | Phase 2 | Data pending (vs adalimumab / placebo) | May 2027 |
Source: The Dermatology Digest
| Drug | Mechanism | Phase | Key Efficacy | Timeline |
|---|---|---|---|---|
| Remibrutinib Novartis |
Oral BTK inhibitor | Phase 3 | Phase 2b: HiSCR50 73% (25mg BID) vs 34.7% placebo | Oct 2028 |
The 73% response rate for remibrutinib in Phase 2b is one of the highest seen in any HS trial. This oral drug is worth watching closely.
Source: Practical Dermatology
| Drug | Mechanism | Phase | Notes |
|---|---|---|---|
| Spesolimab | IL-36 inhibitor | Phase 3 | Targets a different inflammatory pathway entirely |
| HB0043 | Bispecific IL-17/IL-36 | Phase 1/2 | Dual-targeting approach; early 2026 data |
| CIT-013 | Anti-citrullinated histone (disrupts NETs) | Phase 2 | Entirely novel mechanism; Jul 2027 |
| Tulisokibart | Anti-TNF-like cytokine 1A | Phase 2 | New target (Merck); Jan 2029 |
| Tibulizumab | Bispecific BAFF/IL-17A | Phase 2 | Dual-targeting B-cells + IL-17; Q3 2026 |
Source: Practical Dermatology
Beyond traditional biologics, several genuinely novel approaches are showing early promise.
Nature Communications, Dec 2025
Personalized phage therapy targeting Staphylococcus aureus in a 52-year-old female HS patient resulted in complete lesion removal and a 6-month flare-free period. This attacks the bacterial colonization driving flares rather than the immune response itself — a completely different paradigm.
Read the study →UCSF / bioRxiv, Feb 2026
Computational transcriptomics identified three existing FDA-approved drugs that reverse the HS gene signature: sirolimus (mTOR inhibitor), pioglitazone (diabetes drug), and fulvestrant. All three suppressed pro-inflammatory cytokines in ex vivo HS skin models — potential fast-track repurposing opportunities.
Read the preprint →Multiple studies, 2025–2026
Semaglutide and tirzepatide — the widely known weight-loss drugs — are improving HS outcomes as off-label add-ons. Over half of HS patients on semaglutide reported symptom improvement. These drugs suppress TNF-α and IL-17 (the same targets as HS biologics) while also reducing body weight and metabolic inflammation.
JEADV, Nov 2025
Researchers identified distinct epithelial "endotypes" in HS driven by hair follicle stem cell fate. This suggests that treatments could be stratified based on the specific type of epithelial dysfunction — a step toward truly personalized HS medicine.
Read the study →A 10-year Danish community cohort study published in JAMA Dermatology (Jan 2026) found that hospital-based estimates dramatically overstate HS progression and understate remission.
Community-based remission rates were 3.8x higher and progression to severe disease 10.4x lower than hospital-based estimates. Hospital cohorts likely overstate severity because they capture the hardest cases.
Source: JAMA Dermatology, Jan 2026
Research published in Frontiers in Immunology (2025) confirmed several modifiable factors that affect HS outcomes.
Physical activity intensity is inversely correlated with disease severity. A Mediterranean diet combined with regular exercise showed the most pronounced benefits.
Source: Frontiers in Immunology, 2025