Of all variables associated with poor response of patients with hidradenitis suppurativa (HS) to the drug adalimumab, the occurrence of a flare before week 12 was associated with the highest risk of no response, according to a study published in the Italian Journal of Dermatology and Venereology. Investigators researching the role of flare outbreak as a possible predictive factor of response to adalimumab conducted a retrospective analysis that included 115 patients with moderate-to-severe HS in treatment with adalimumab, with three or more abscesses and inflammatory-nodules. Information about gender, age at onset/baseline, therapeutic delay, family history, BMI, smoking, comorbidities, phenotypes, body areas, and severity indexes at baseline was collected. Baseline characteristics, and total number and timeline of flares were analyzed by regression and survival analysis with Hidradenitis Suppurativa Clinical Response. During the observational period, 80.9% of patients developed a total of 252 flares. Univariate models identified five factors associated with the absence of response to the medication: age, comorbidities, genital-perineal involvement, no response at week 12, and flares outbreak. Joint analysis of recurrent and terminal events showed a positive correlation between flare recurrence and no response.