How Translational Biomarker Research Could Change The Trajectory Of Hidradenitis Suppurativa

By Elisa Maggioli, Ph.D., senior director, new product planning & research lead, UCB

Hidradenitis suppurativa (HS) remains one of the most complex and underserved inflammatory conditions in dermatology. HS Awareness Week, which occurred June 1-7 this year, highlighted the significant scientific and clinical challenges that remain. To mark the milestone, UCB published the 2026 HS Vision Progress Report, outlining our ongoing efforts across the three pillars of our commitment that guide our work in HS: revolutionize science, redefine care, and restore humanity.

Despite growing awareness, HS continues to present substantial challenges in both clinical care and new treatment research and development.^1,2 Patients still experience, on average, a 7.3‑year delay to diagnosis and highly variable outcomes following treatment initiation.^3,4 The research around this disease remains relatively under-funded compared with other inflammatory skin conditions,⁵ reinforcing the need for deeper biological understanding.^1,6

Increasingly, HS is recognized as a biologically heterogeneous condition,⁷ where patients may experience markedly different disease trajectories and responses to treatment.⁷ This complexity has important implications for how preclinical research is designed, interpreted, and ultimately translated into meaningful patient outcomes.

HS is characterized by a wide range of disease presentations, but these differences are not yet fully understood or routinely accounted for in clinical research.⁸ As a result, it can be challenging to interpret variation in treatment response and may hinder efforts to identify the most relevant therapeutic targets for different disease subgroups.⁸ There is growing recognition, however, that improving outcomes in HS may depend on moving beyond broad, symptom-based approaches toward more targeted, biologically informed strategies.²

From Biological Insight To Clinical Application

Advances in molecular and translational research are beginning to provide deeper insight into the biological mechanisms underlying HS.² Within this evolving landscape, biomarkers are emerging as a potential bridge between scientific discovery and clinical application.⁹

While specific biomarkers in HS are still under investigation and not yet validated for routine clinical use,⁹ current research is increasingly focused on identifying biological signals that reflect how the disease develops and progresses in different patients.⁹ This includes assessing biomolecular and structural characteristics of affected skin tissue, as well as pathobiological patterns associated with differing rates of disease progression.^2,10 Collectively, these approaches aim to build a more comprehensive biological understanding of HS.

From a research perspective, biomarker-informed approaches could help address some of the challenges associated with variability of response in HS. By supporting more refined patient stratification, biomarkers may help distinguish between different disease subtypes or progression patterns.^9,11 This could enable clinical trials to move toward more defined patient populations, based not only on clinical presentation but also on underlying biological drivers, and support the development of more targeted therapies.^9,11

Biomarkers are also likely to play a role in evolving clinical practice. While the heterogeneity of HS and lack of defined phenotypes pose a major challenge,^7,11 biomarkers are being explored as tools to improve understanding of the underlying disease biology. Better characterization of the biological factors associated with different disease stages of HS and accelerated disease progression could help predict patients most likely to respond well to treatment, as well as those at higher risk of more severe or rapidly progressing disease.^11,12

Generating Evidence Through Human Research

These concepts are being actively explored through research grounded in human disease biology. For example, UCB is collaborating with Stanford University on a biomarker study investigating the biological factors associated with different rates of HS progression, with patients often described as “fast” versus “slow” progressors.

This work integrates patient-derived samples with advanced molecular and spatial analysis techniques to better understand how the disease starts and evolves.¹³

Insights from such studies may help identify individuals at higher risk of more rapid disease progression, which could have implications for both clinical research and clinical care.⁹ Earlier identification of these patients may support more proactive and timely treatment strategies, particularly in the context of a potential window of opportunity where intervention could influence long-term outcomes.^7,9

Implications For Clinical Development

As biomarker research continues to evolve, it may influence how clinical trials in HS are designed and conducted. More biologically defined patient populations could support study designs that are better aligned with specific pharmacological mechanisms, potentially improving the clarity and interpretability of trial outcomes.^8,9

This approach also highlights the importance of timing in HS. Evidence from other inflammatory diseases suggests that earlier intervention may influence long-term disease trajectory,¹⁴ and this concept is increasingly being explored in HS.⁷ Biomarkers could contribute by helping to identify patients earlier in the disease course, or those at greater risk of progression, supporting more timely and targeted treatment decisions.^9,11

However, translating these advances into clinical practice remains a complex process. Further validation is required to ensure the reliability and applicability of potential biomarkers, and their integration into clinical trials and care pathways will depend on the generation of robust evidence and alignment with regulatory frameworks.⁹

Bridging Science And Care Through The HS Vision

Ultimately, advancing science in HS is not an endpoint in itself — it is a critical enabler of better care. Within UCB’s HS Vision, the “Revolutionize Science” pillar is designed to strengthen the scientific foundations needed to drive progress across the care pathway.¹⁵

Biomarkers offer one pathway to help bridge advances in biological understanding with real-world clinical decision-making.⁹ By supporting earlier diagnosis, more precise patient stratification, and more informed treatment approaches, they have the potential to reshape both research and care.^11,16

As HS Awareness Week 2026 highlighted both the unmet need and the opportunity for progress, it also reinforced the importance of sustained collaboration across research, clinical, and healthcare communities. By continuing to invest in human-centered research and translating scientific insights into practice, it may be possible to move toward a more proactive and precise approach to HS, one that better reflects the complexity of the disease and improves outcomes for the people living with it.

References:

1. Global Hidradenitis Suppurativa Atlas. Global Report on Hidradenitis Suppurativa. Available: https://ilds.contentfiles.net/media/documents/Global_Report_on_Hidradenitis_Suppurative_
   HS_2023.pdf. Last accessed: June 2026.
2. Zouboulis CC, et al. Exp Dermatol. 2020;29(1):1154-70.
3. Barmatz S, et al. Dermatology. 2022;238(4):772–84.
4. Nguyen TV, et al. J Eur Acad Dermatol Venereol. 2021;35(1):50–61.
5. Lui X, et al. Interact J Med Res. 2025;14:e70282.
6. Caucheteux SM, et al. JID Open. 2026;146(3):1-12.
7. Bechara FG, et al. Dermatol Ther (Heidelb). 2025;15(9):2317-33.
8. van Straalen KR, et al. J Clin Invest. 2024;134(21):e186744.
9. Der Sarkissian S, et al. JAMA Dermatol. 2022;158(3):300-13.
10. Caucheteux SM, et al. Br J Dermatol. 2024;190(6):e67.
11. Moltrasio C, et al. Dermatology. 2023;239(5):836-839.
12. Molinelli E, et al. Med. 2024;5(10):1197-9.
13. UCB Data on File. 2026. Structural and Molecular Determinants of Early HS Progression. p1–14.
14. Carter LM, et al. J Invest Dermatol. 2022;142(3):944-50.
15. UCB. Imagine An HS-Free World. Available : https://www.ucb.com/sites/default/files/2026-06/UCB_HS_Vision_Report_2026_V4_29052026.pdf. Last accessed: June 2026.
16. Groen SS, et al. JAAD. 2022;87(3):AB86.

About The Author :

Elisa Maggioli, Ph.D., is senior director, new product planning & research lead, at UCB, where she helps bridge scientific innovation and strategic development across immunology and inflammatory diseases. With more than 11 years’ experience in biomedical science and research, Elisa has built her career advancing the understanding of immune-mediated and neuroinflammatory conditions, from academic discovery research through to drug development. Passionate about translating scientific insights into meaningful patient outcomes, Elisa is particularly interested in advancing approaches that can improve care for people living with complex chronic diseases.