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HiSCR

HiSCR: The gold standard clinical response endpoint for Hidradenitis Suppurativa trials.

Baseline (Pre-treatment)

Abscess/Nodules (AN)
0
Abscesses
0
Draining Tunnels
0

Current Evaluation

Abscess/Nodules (AN)
0
Abscesses
0
Draining Tunnels
0

Compare Baseline

Enter lesion counts from before treatment (baseline) and today (current) to see if clinical response has been achieved.

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

When to Use

Evaluating the efficacy of treatments for moderate-to-severe Hidradenitis Suppurativa (HS).
Primary clinical endpoint used in Phase III biologic trials (e.g., Adalimumab, Secukinumab).
Monitoring patient response to systemic therapy in outpatient dermatology clinics.

When NOT to Use

Not intended for patients with mild HS (fewer than 3 abscesses/inflammatory nodules at baseline).
Does not measure the extent of scarring or fistulas (for staging, use Hurley Stage or IHS4).

How it Works

Definition of HiSCR Achievement

Achieving HiSCR (also known as HiSCR50) requires ALL THREE of the following criteria compared to baseline:
1. ≥ 50% reduction in the total Abscess and Inflammatory Nodule (AN) count.
2. NO increase in the number of abscesses.
3. NO increase in the number of draining fistulas.

Clinical Pearls

Clinical Pearls

HiSCR isolates the reversible, inflammatory components of the disease (abscesses and nodules) while appropriately penalizing therapies that allow draining fistulas or abscesses to worsen.
Because non-inflammatory lesions (scars, inactive fistulas) do not change with medical therapy, excluding them from the reduction criteria allows for a more sensitive assessment of drug efficacy.
To calculate HiSCR, the clinician must obtain a precise baseline count of abscesses, inflammatory nodules, and draining fistulas prior to initiating therapy.
Newer benchmarks such as HiSCR75 and HiSCR90 (75% and 90% reductions in AN count, respectively) are increasingly used to denote deeper clinical responses.

Next Steps

Clinical Action

01
If HiSCR is achieved: Continue the current systemic regimen (e.g., TNF-alpha or IL-17 inhibitor) and address residual scarring/fistulas with targeted surgical interventions if necessary.
02
If HiSCR is NOT achieved (e.g., after 12-16 weeks of biologic therapy): Consider dose escalation, switching biologic classes, or adding adjunctive therapies (e.g., oral antibiotics, hormonal modulators).

The Evidence

Primary Reference

Assessing the validity, responsiveness and meaningfulness of the Hidradenitis Suppurativa Clinical Response (HiSCR) as the clinical endpoint for hidradenitis suppurativa treatment.

Kimball AB et al. • Br J Dermatol.. 2014;171(6):1434-1442. Demonstrated that achieving HiSCR corresponds with significant improvements in patient-reported outcomes and quality of life.

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External Links

Origins & History

Last Comprehensive Review: 2026-07-17

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IHS4
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