Background and objectives: Evidence for secukinumab and bimekizumab in hidradenitis suppurativa (HS) primarily comes from randomized clinical trials with selected patient populations. Conversely, real-world evidence (RWE) studies reflect broader patient demographics and clinical practice. This study aims to summarize RWE on the safety and efficacy profile of secukinumab and bimekizumab for HS through a systematic review and meta-analysis.

Methods: We conducted a comprehensive search using the Medline and Scopus databases. Eligible studies reported RWE on secukinumab or bimekizumab in HS. Furthermore, we conducted a meta-analysis to estimate the proportion of patients achieving HiSCR with secukinumab.

Results: A total of 13 studies were included, with 347 HS patients. The meta-analysis showed that 50.31% (95%CI, 37.41% - 63.18%) of patients on secukinumab achieved HiSCR at the longest follow-up available. While HiSCR was not reported for bimekizumab studies, significant improvements in IHS4 and pain-NRS were observed. Both drugs were well-tolerated, with adverse event rates of 8.22% for secukinumab and 5.45% for bimekizumab, most being mild and manageable.

Conclusions: IL-17 inhibitors provide moderate response rates and are valuable options for patients refractory to other therapies, with low incidences of mild adverse events. More RWE studies are essential to better understand their safety and efficacy profile.