ClinicalTrials.gg
Not yet recruitingNCT07756346Botox in HSUpdated Sep 10, 2026

Botulinum Toxin Blockade of Neuronal Signals to Immune Cells as a Novel Treatment for Hidradenitis Suppurativa

A Phase 2 interventional study of Botulinum Toxin A (Allergan, Inc, Irvine CA) and Placebo in Hidradenitis Suppurativa (HS), sponsored by University of Massachusetts, Worcester. Not yet recruiting at 1 site in United States. Open to participants aged 13 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-09-10.

Sponsored by University of Massachusetts, Worcester · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
40
Allocation
Randomized
Ages
13 Years to 75 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-13

Among 161 studies in Hidradenitis Suppurativa with a site in United States — 38 open to participants now, 55 under way, 12 of them phase 3. Hidradenitis Suppurativa · United States.

Planned enrollment
73rd of 139
40 · median 45
Started
2026
with 16 others
Phase 2
61 of 161
11 open now
Primary completion
2028-09
later than 45 of 54 live
Registered
154th of 161
by date

Among the 161 studies in Hidradenitis Suppurativa with a site in United States, this one is the 73rd largest by planned enrollment of the 139 interventional ones that give a count, is one of 17 that started in 2026, is one of 61 in phase 2, reaches primary completion later than 45 of the 54 other live ones, and was the 154th registered.

Hidradenitis Suppurativa

285 studies on the registry are indexed under Hidradenitis Suppurativa; 88 are open to participants now.

Browse Hidradenitis Suppurativa studies →

Open to participants now

38 of the 161 studies in Hidradenitis Suppurativa with a site in United States are open now. Recruiting first, the newest first:

33 more — sign in →

All 38 open studies →

A study can be open while its sites in United States have not opened yet or have stopped. Only those recruiting at a site in United States →

Who these studies take

Of the 61 Hidradenitis Suppurativa studies recruiting now, 33 (54%) set no upper age limit and 17 (28%) stop at 75 or younger; 13 take children under 18; 12 take healthy volunteers.

This study: 13 Years to 75 Years · all sexes · no healthy volunteers.

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 161 studies in Hidradenitis Suppurativa with a site in United States, or all of them as a file.
02

Study summary

This study will build on data from mice and humans implicating TRPV1 nociceptors in the pathogenesis of the type-17 chronic inflammatory skin disease hidradenitis suppurativa (HS). In this study, the investigators will extend data from a 12-week pilot study to rigorously test the hypothesis that botulinum toxin (BoNT) therapy reduces disease severity and relieves HS pain symptoms..

Read the detailed description

This study will recruit 40 HS patients with an abscess and inflammatory nodule (AN) count ≥5 at a single body site (ex. bilateral axillae, medial thighs). Participants will be randomized 1:1 to receive placebo or 50U of BoNT per 100cm2 of skin (100U total) administered twice over a 6-month study period. Randomization will be stratified by disease stage (Hurley stage \<III, III). At baseline and weeks 4, 12, and 24 disease activity and pain symptom burden will be measured using percent change from baseline in abscess and inflammatory nodule (AN) count and draining tunnel (dT) count as primary outcomes and achievement of ≥ 30% reduction from baseline in the Patient's Global Assessment of Skin Pain Numeric Rating Scale (NRS)-30 as a secondary outcome. The investigators will conduct high-frequency ultrasound measurement of HS tunnel area at baseline and weeks 4,12, and 24 to determine if BoNT therapy can reduce tunnel size. The study team will also collect punch biopsies of lesional skin from HS patients before, and 4 weeks after BoNT treatment then perform flow cytometric, transcriptomic, and microscopic analysis of skin to determine if and how nonselective inhibition of neuropeptide release diminishes HS inflammation.

03

Conditions studied

  • Hidradenitis Suppurativa (HS)

Keywords

  • botulinum toxin
  • Botox
  • ultrasound
  • tunnel area
  • mechanistic
04

Who can participate

Ages eligible
13 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age >13 and \<75
  • established diagnosis of HS
  • HS skin lesions of duration at least 1 year
  • HS lesions in at least two distinct body areas
  • inadequate response to a trial of an oral antibiotic or exhibited recurrence after discontinuation of antibiotics
  • abscess and nodule (AN) count ≥ 5 at baseline
  • draining tunnel count of \<20 at baseline
  • ability to provide written and/or assent

Exclusion criteria

Exclusion Criteria:

  • pregnant or breastfeeding
  • history of neuromuscular disorder (ex. ALS, myasthenia gravis, Lambert-Eaton syndrome, myopathy
  • medical co-morbidity ex. end stage congestive heart failure or coagulopathy that is a relative contradiction to skin procedure
  • received systemic or started a new systemic (biologic or non-biologic immunomodulator, oral retinoid) therapy with potential therapeutic impact for HS \<12 weeks prior to baseline visit
  • use of opioid or non-opioid oral analgesics within 14 days of baseline visit (exception: at a stable dose for at least 14 days prior to baseline)
  • receiving anti-IL-17A/F, anti-IL-23, or anti-IL-1 biologic therapy or oral JAK inhibitor, TYK inhibitor
  • active COVID-19 infection or history of COVID-19 infection within 4 weeks prior to baseline
  • oral or IV antibiotic use during the treatment period (exception: stable dose of doxycycline or minocycline upto 100mg PO BID for 28 days prior to baseline and throughout the 6 month treatment and observation period
  • initiation of topical therapies for HS within 14 days or baseline visit (may continue stable use of topical therapies started > 14 days prior to baseline visit), -laser surgery, laser hair removal, or elective surgery to treatment areas within 4 weeks prior to baseline visit
  • current participation in another clinical study involving the administration of an investigative drug for the treatment of HS, or prior participation in such a study within 60 days prior to baseline visit,
  • active bacterial, fungal, or viral infection in the treatment area at baseline visit, - state
  • known to botulinum toxin A preparations or any of their components (human albumin, saline, lactose, sodium succinate).
Terms in these criteria, in plain language(5)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
40 participants (estimated)

Study arms

  • Placebo comparator
    placebo

    Participants will be randomized 1:1 to receive placebo (saline) or botulinum toxin injections.

    Drug: Placebo

  • Active comparator
    botulinum toxin

    Participants will be randomized 1:1 to receive placebo (saline) or botulinum toxin injections.

    Drug: Botulinum Toxin A (Allergan, Inc, Irvine CA)

Interventions

06

What researchers measure

Primary outcomes

  1. percent change from baseline in abscess and inflammatory nodule (AN) count and draining tunnel (dT) count

    All subjects will receive 2 treatments with onabotulinum toxin A OR placebo (saline) 3 months apart, over a 6-month study period. At baseline and at week 12 each patient will receive 50 units of Botox per 100cm2 of skin, injected intradermally in 10 injections of 0.1mL spaced 1 cm apart to one HS-affected body site (ex. bilateral axillae, inguinal, medial thighs, inframammary chest) for a total of 100U per treatment.

    Time frame: baseline and weeks 4, 12, and 24

  2. Microscopy Analyses of Skin Lesions

    The study team will perform punch biopsies of lesions and non-lesional skin and perform direct immunohistochemistry and immunofluoresce microscopy analysis

    Time frame: baseline and day 7

  3. Ultrasound monitoring of skin lesions

    Ultra-high frequency ultrasound (UHFU): This non- invasive imaging technique will be used to quantify HS tunnel area and cutaneous blood flow rate in treatment areas using an established protocol as detailed in Oranges T Skin Res Technology 2020).

    Time frame: baseline and weeks 1, 12, 24

Secondary outcomes

  1. Hidradenitis Suppurativa Investigator Global Assessment (HS-IGA)

    Response is defined as at least a 2-point reduction in HS-IGA score relative to baseline.

    Time frame: baseline and weeks 1, 12 ,24

  2. Central sensitization Index (CSI)

    measures centrally processed pain signals. The participant scores each answer on a scale of 0 (never) to 4 (always). A score of more than 40 indicates the presence of central sensitization.

    Time frame: baseline and weeks 1, 12, 24

  3. Numeric Rating Scale -30

    The numeric rating scale (NRS) is a pain scale that asks a patient to rate their pain on a scale of 0 to 10 where a higher score indicates a higher pain level. It's a common tool used in healthcare to assess pain severity.

    Time frame: baseline and weeks 1, 12, 24

  4. Hidradenitis Suppurativa Clinical Response (HiSCR)-50

    defined as a 50% reduction in inflammatory lesion count (abscesses + inflammatory nodules) with no increase in abscesses or draining fistulas when compared with baseline.

    Time frame: baseline and weeks 1, 12, 24

  5. Hidradenitis Suppurativa Physician Global Assessment (HS-PGA)

    The six-point Hidradenitis Suppurativa Physician Global Assessment (PGA) ranges from clear to very severe where a higher score indicates more severe disease. It is used in clinical trials to measure clinical improvement in inflammatory nodules,abscesses and draining fistulae

    Time frame: baseline and weeks 1, 12, 24

  6. Hidradenitis Suppurativa Quality of Life (HiSQOL)

    A 17-item questionnaire designed to measure quality of life for people with HS. Scores range from 0-68 where higher scores indicate a worse impact on quality of life.

    Time frame: baseline and weeks 1, 12, 24

  7. Dermatology Quality of Life Index

    Assesses the degree of pain, the number of flares, and the impact on daily life . Dermatology disease agnostic, not specific for HS

    Time frame: baseline and weeks 1, 12, 24

  8. International Hidradenitis Suppurativa Severity Score (IHS-4)

    The International Hidradenitis Suppurativa Severity Score (IHS4) is a validated tool that measures the severity of hidradenitis suppurativa (HS). The IHS4 score is calculated by adding the number of nodules, abscesses, and draining tunnels, each multiplied by a weight A score of 3 or less indicates mild HS, 4-10 indicates moderate HS, and 11 or higher indicates severe HS. The IHS4 is used to assess the severity of HS and to measure inflammatory lesions, such as draining tunnels.

    Time frame: baseline and weeks 1, 12, 24

  9. Hidradenitis Suppurativa Area and Severity Index Revised

    The HASI-R method assesses HS severity in a manner that incorporates signs of inflammation and body surface area involved. Scores range from 0-720 where a higher score indicates worse disease.

    Time frame: baseline and weeks 1, 12, 24

  10. Numeric Rating Scale - Itch

    rates itch score as 1-10, 10 indicating most severe itch. similar to NRS pain instrument

    Time frame: baseline and weeks 1, 12, 24

  11. PainDETECT

    an assessment tool for neuropathic pain. Scores range from -1 to 38. A score of 19 or higher indicates neuropathic pain is likely.

    Time frame: baseline and weeks 1, 12, 24

  12. Generalized Anxiety Disorder-7 (GAD-7)

    The GAD-7 (General Anxiety Disorder-7) measures severity of anxiety over a 2 week period. Answers are scored from 0 to 3 ("not at all" = 0, "several days" = 1, "more than half the days" = 2, and "nearly every day"=3). A score of 10 or higher is considered positive for anxiety.

    Time frame: baseline

  13. Patient Health Questionnaire-9 (PHQ-9)

    The PHQ-9 (Patient Health Questionnaire-9) objectifies and assesses degree of depression severity via questionnaire. Nine questions indicate how often the symptom occurred over a 2-week period. A score of 10 or higher is considered clinically significant.

    Time frame: baseline and weeks 1, 12, 24

07

Study locations

1 site
08

References and documents

Publications

  • Kim YS, Hong ES, Kim HS. Botulinum Toxin in the Field of Dermatology: Novel Indications. Toxins (Basel). 2017 Dec 16;9(12):403. doi: 10.3390/toxins9120403. PubMed 29258169 ↗
  • Kimball AB, Sobell JM, Zouboulis CC, Gu Y, Williams DA, Sundaram M, Teixeira HD, Jemec GB. HiSCR (Hidradenitis Suppurativa Clinical Response): a novel clinical endpoint to evaluate therapeutic outcomes in patients with hidradenitis suppurativa from the placebo-controlled portion of a phase 2 adalimumab study. J Eur Acad Dermatol Venereol. 2016 Jun;30(6):989-94. doi: 10.1111/jdv.13216. Epub 2015 Jul 22. PubMed 26201313 ↗
  • Campanati A, Martina E, Giuliodori K, Consales V, Bobyr I, Offidani A. Botulinum Toxin Off-Label Use in Dermatology: A Review. Skin Appendage Disord. 2017 Mar;3(1):39-56. doi: 10.1159/000452341. Epub 2017 Feb 1. PubMed 28612001 ↗
  • Grimstad O, Kvammen BO, Swartling C. Botulinum Toxin Type B for Hidradenitis Suppurativa: A Randomised, Double-Blind, Placebo-Controlled Pilot Study. Am J Clin Dermatol. 2020 Oct;21(5):741-748. doi: 10.1007/s40257-020-00537-9. PubMed 32761500 ↗
  • Shih T, Lee K, Seivright JR, De DR, Shi VY, Hsiao JL. Hyperhidrosis treatments in hidradenitis suppurativa: A systematic review. Dermatol Ther. 2022 Jan;35(1):e15210. doi: 10.1111/dth.15210. Epub 2021 Nov 30. PubMed 34796606 ↗
  • Campanati A, Martina E, Giuliodori K, Bobyr I, Consales V, Offidani A. Two cases of Hidradenitis suppurativa and botulinum toxin type a therapy: A novel approach for a pathology that is still difficult to manage. Dermatol Ther. 2019 May;32(3):e12841. doi: 10.1111/dth.12841. Epub 2019 Feb 10. PubMed 30693648 ↗

Individual participant data

Plan to share: Yes — Research team will share data and samples from this study with other investigators who are interested in skin diseases, but in that case no patient identifying information will be shared.

Supporting information: Study protocol, Statistical analysis plan, Informed consent form, Clinical study report, Analytic code

Time frame: starting at time of publication of results, ending 7 years following study endpoint

Access criteria: Proposals should be directed to sarah.whitley@umassmed.edu.To gain access to data, requesters will have to sign a data access agreement.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Oct 2026; primary completion for Sep 2028, 23 months later.

Of 54 phase 2 interventional studies under Hidradenitis Suppurativa, half reached primary completion within 15 months of starting (the median), counting those still running; a quarter within 11 and three quarters within 24. This study's planned 23 months is above that.

How these figures are worked out, and which studies are left out of them.

Registered
Aug 4, 2026
First posted
Aug 10, 2026
StartEst.
Oct 2026
Primary completionEst.
Sep 2028
CompletionEst.
Apr 2029
Last update
Sep 10, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 10, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07756346
Collaborators
Emory University
Responsible party
Sarah Whitley (Assistant Professor of Dermatology, University of Massachusetts, Worcester) — Principal investigator
First posted
Aug 10, 2026
Start date
Oct 2026 (estimated)
Primary completion
Sep 2028 (estimated)
Completion
Apr 2029 (estimated)
Last update
Sep 10, 2026

Study contacts

Sarah K Whitley, MD, PhD
Contact
sarah.whitley@umassmed.edu
508-856-4086
Terrie LaMarche
Contact
terrie.lamarche@umassmed.edu
Sarah K Whitley, MD, PhD
principal investigator · UMass Chan Medical School

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.

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Discussion

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Studies of the drug tested here: Botulinum toxin type A

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