John is a 35-year-old male with moderate-to-severe hidradenitis suppurativa (HS) who has been treated with secukinumab 300 mg every 2 weeks for 52 weeks and achieved a Hidradenitis Suppurativa Clinical Response (HiSCR). He is now entering the maintenance phase of therapy. John is concerned about the risk of disease relapse if treatment is interrupted. His medical history is otherwise unremarkable, and he has no known drug allergies.

Question: Based on the SUNSHINE and SUNRISE extension trial results, what is the most appropriate counseling point regarding continuation versus withdrawal of secukinumab therapy in John’s case?

Maria is a 42-year-old female with moderate-to-severe hidradenitis suppurativa who has been on secukinumab 300 mg every 4 weeks for 18 months. She reports no significant adverse effects but is concerned about the safety of continuing biologic therapy long term. Her past medical history includes well-controlled hypertension and no history of infections.

Question: What does the evidence from the SUNSHINE and SUNRISE extension trial suggest about the long-term safety of secukinumab in patients like Maria?

David is a 29-year-old male with moderate-to-severe hidradenitis suppurativa who has been treated with secukinumab 300 mg every 4 weeks for 52 weeks and achieved HiSCR. During follow-up, he experiences an increase in lesion count, raising concerns about loss of response (LOR). He asks about the likelihood of maintaining clinical benefit despite this change.

Question: According to the SUNSHINE and SUNRISE extension trial findings, how should the pharmacist interpret and counsel David regarding clinical response and loss of response while on secukinumab?