Do you prefer switching to a biologic with a different mechanism of action such as an IL-17 inhibitor over cycling to another TNF inhibitor in a patient with moderate-to-severe HS who has experienced secondary failure to adalimumab after an initial good response?

I agree with @Dr. First Last's excellent suggestions. One other idea is adding methotrexate 10 mg weekly to adalimumab to see if neutralizing antibodies are the problem. I tend to do this if a patient has a good response but loses it down the road. I don't do this as much as I used to, now that we h...

I would first consider trying to increase adalimumab to 80 mg weekly dosing if they are flaring at the standard dosing regimen. Because the only other biologics that are currently FDA-approved are IL-17i, I would switch to secukinumab or bimekizumab if they fail adalimumab at the higher dose. Inflix...