The Role of Specialty Pharmacy in Hidradenitis Suppurativa Care at University of Vermont (UVM) Health| NASP Specialty Pharmacy Podcast

Ryan Lackey (0:05)

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You're listening to the NASP Specialty Pharmacy Podcast, a collaboration between the National Association of Specialty Pharmacy and the Pharmacy Podcast Network. Each episode dives deep into trends, challenges, innovations and patient-centric practices, shaping the future of this dynamic and rapidly evolving industry. Whether you're a pharmacist or healthcare provider, patient advocate or industry leader, you'll hear expert insights, real world evidence and thought-provoking discussion that highlights all that makes Specialty Pharmacy special.

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In support of NASP's mission to empower specialty pharmacy stakeholders to advance the standard of patient care. NASP supports a free market healthcare system in which all specialty pharmacies compete on the same fair and level playing field because that is in the best interest of the patients we collectively serve. NASP is committed to working with all stakeholders and policy makers to ensure that all patients have access to the life-saving medications they need and the high-touch patient care and support services they deserve from the pharmacy of their choosing.

Sheila Arquette (1:30)

Hello, my name is Sheila Arquette and I am the president and CEO of the National Association of Specialty Pharmacy. I am delighted to welcome my special guests, Santana VanDyke, MD, and Ryan Lackey, PharmD, CPPS, to this episode of the NASP Podcast.

Santana VanDyke is an assistant professor of dermatology and the director of the Hidradenitis Suppurativa Clinic at University of Vermont Health. She earned her medical degree at the University of Virginia School of Medicine and completed her dermatology residency at UVM Health. She is very passionate about resident fellow teaching and was awarded the 2025 Graduate Medical Education Educator of the Year at UVM Health. With the help of her wonderful team, she strives to provide the most compassionate advanced care for HS patients and is passionate about research to advance treatments and patient-centered care for HS patients.

Ryan Lackey is an ambulatory pharmacist clinician at the University of Vermont Health Specialty Pharmacy, supporting the dermatology clinic and the co-director of the Hidradenitis Suppurativa Clinic. He earned his pharmacy degree from the Albany College of Pharmacy and Health Sciences and completed his pharmacy residency training in ambulatory care and specialty pharmacy at Dartmouth Health. He is passionate about optimizing medication management, comprehensive patient care, and prioritizing safety to enhance patient outcomes. Santana and Ryan, thanks so much for joining me today.

Santana VanDyke (3:04)

We're happy to be here. Thanks for having us.

Ryan Lackey (3:06)

Yes. Thank you so much for having us.

Sheila Arquette (3:09)

Can you please give us a brief overview of Hidradenitis Suppurativa, the presentation, the staging, and common treatments?

Santana VanDyke (3:18)

Absolutely. So HS, or Hidradenitis Suppurativa, is a very complex condition that we treat primarily in dermatology, but we certainly work with other specialists as well to provide comprehensive care. But it's essentially an auto-inflammatory condition. So what that means is the system just has a lot of inflammation, and in HS it's actually primarily affecting the hair follicles. And this can lead to painful cysts and abscesses, mostly in the armpits, groin, and under the breasts for some people.

And it can lead to inflammation that actually tunnels under the skin and forms what we call skin tunnels, as well as significant scarring. And it can be really, really debilitating for patients because it can be quite painful, they can have a lot of drainage, which can affect social life, work, and mental health definitely. And then in terms of age, really anyone can get HS. We most commonly see it present in women in their 20s and 30s, as well as teenagers, but people can also get it later in life, and it affects both men and women.

And then in terms of staging, there are a variety of staging methods, but we primarily use the Hurley staging system, which is based on the amount of scarring and skin tunneling that patients have. And there are a variety of treatments. We wish there were more treatments available, but we finally do have some. It's a condition that really wasn't studied for a very long time. So really in the last 10, 15 years, they've been doing a lot of research on medication. So we have some topicals that we use, like chlorhexidine, which is an antiseptic solution, as well as clindamycin lotion. We do some oral medications, such as doxycycline, which helps with inflammation, spironolactone can help if there's a possible hormonal component, which I'm sure we'll chat a little bit about later. And then the FDA approved medications are adalimumab, secukinumab and bimikizumab, which are all biologic medications that help with the inflammation.