What biologics have you found to be most effective in treating hidradenitis suppurativa?

I'll answer the easy part of the question first. For insurance coverage, the HS Foundation website has wonderful prior auth letter templates for biologics, laser therapy, and other treatments. I have had a lot of successes in getting off-label biologics covered with them. It doesn't always work, but definitely makes life easier. https://www.hs-foundation.org/for-clinicians#prior_authorization

As for choice of biologic, like every treatment with HS, it's nearly impossible to predict what will work for an individual patient. I use a lot of adalimumab as a first biologic. Approval tends to be simple since it's FDA-approved. There are no head-to-head trials, but in clinical experience, infliximab is the most effective. This is probably because y...