INF904 Oral C5aR Inhibitor Offers a Potential Non-Surgical Treatment for Hidradenitis Suppurativa

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HEADLINE

INF904 Oral C5aR Inhibitor Offers a Potential Non-Surgical Treatment for Hidradenitis Suppurativa

SUMMARY

INF904, an oral small-molecule inhibitor targeting the C5a receptor (C5aR), has demonstrated promising early clinical results in reducing lesion burden and pain in patients with hidradenitis suppurativa (HS), offering a potential non-surgical alternative for this debilitating chronic skin disease, says New York dermatologist Dr. Dennis Porto.

BACKGROUND: Hidradenitis Suppurativa AND UNMET NEED

Hidradenitis suppurativa (HS) is a chronic, often painful skin disease characterized by recurrent inflamed nodules, abscesses, and draining tunnels, typically in intertriginous areas such as underarms, groin, and buttocks. The disease can progress to complex sinus tracts and scarring, significantly impacting quality of life and carrying substantial physical and psychosocial burden. :contentReference[oaicite:1]{index=1}

Current treatments include antibiotics, biologics, immunosuppressants, and — for advanced disease — surgical excision or CO₂-laser removal of lesions. Surgery remains the “gold standard” to remove deeply scarred or tunnelled tissue, but it carries morbidity and does not always prevent recurrence. Many patients remain inadequately controlled or relapse, highlighting an urgent need for safer, effective, non-surgical options.

NEW DEVELOPMENT: WHAT IS INF904

INF904 is an oral, low-molecular-weight antagonist of the C5a receptor (C5aR1), designed to block complement-mediated neutrophilic inflammation — a key driver in the pathophysiology of HS and certain other inflammatory dermatoses. :contentReference[oaicite:2]{index=2}

In a recent Phase 2a trial across multiple dosing cohorts (60 mg, 90 mg, 120 mg twice daily), INF904 demonstrated rapid and meaningful reductions in inflammatory lesions (abscesses and nodules), draining tunnels, and overall inflammatory burden. Many patients also reported substantial reductions in pain and improvements in quality-of-life scores. :contentReference[oaicite:3]{index=3}

Notably, clinical response rates (HiSCR50) continued to improve even after the dosing period ended, suggesting a sustained immunomodulatory effect. :contentReference[oaicite:4]{index=4}

These early data have generated optimism among dermatologists that INF904 could approach the efficacy of biologics — or even the results historically achieved only via surgical intervention — but in oral pill form. :contentReference[oaicite:5]{index=5}

EXPERT COMMENTARY

“I am so impressed by the data I am seeing for INF904. For years, dermatologists and surgeons have been limited in treatments for this distressing, debilitating condition. In the past I have relied on CO₂ laser excisions for the gold-standard treatment for HS lesions. I’m hopeful that with INF904 we may have a non-surgical option that approaches that efficacy. Colleagues and I have been watching this closely and are hopeful!” said Dr. Dennis Porto, a board-certified Mohs surgeon and dermatologist in New York City.

CLINICAL SIGNIFICANCE AND OUTLOOK

If larger controlled trials confirm safety and efficacy, INF904 could reshape management of moderate-to-severe HS by providing an oral, non-surgical, biologic-level therapy. This would give patients and dermatologists a vital alternative to repeated surgeries, chronic immunosuppressants, or injectable biologics — especially for those seeking convenience or preferring oral medications.

Further studies will need to define optimal dosing, long-term safety, durability of response, and whether INF904 can be used with or as a substitute for existing HS therapies. The dermatology community is watching closely, as complement-pathway modulation may emerge as a new foundational strategy in inflammatory skin disease.

ABOUT DR. DENNIS PORTO

Dr. Dennis Porto, MD, MPH, FAAD, is a double board-certified Mohs micrographic surgeon and dermatologist practicing in New York City. He completed medical school at the University of Iowa, followed by a dermatology research fellowship at Harvard and advanced surgical training in dermatology. Dr. Porto serves as a clinical assistant professor of dermatology at Mount Sinai and is widely published in dermatologic surgery and cosmetic dermatology. His practice integrates medical, surgical, and cosmetic care with a particular focus on evidence-based advancements in skin health.