When topical medications and oral antibiotics for hidradenitis suppurativa (HS) fail, or the disease has progressed, biologic medications can be recommended. Adalimumab, a tumor necrosis factor-α inhibitor, has the most evidence supporting its use. Two open-label, phase II, randomized controlled trials (RCTs) determined that weekly dosing of adalimumab statistically improved clinical response when compared to placebo controls (see {1,2}). Following these studies, this study conducted two phase III trials, PIONEER I and II, which described statistically improved clinical response in the adalimumab treatment group compared to placebo after 12 weeks. Specifically, 41.8% of the treated group reached HS clinical response compared to 26.0% of the placebo group in PIONEER I (p=0.003) and 58.9% versus 27.6% in PIONEER II (p<0.001), respectively. PIONEER II also noted a statistically significant improvement in Sartorius score, from a mean of 81.4 before treatment to 52.5 at week 12 (p<0.001). This Recommendation is of an article referenced in an F1000 Faculty Review also written by Mallory K Smith, Cynthia L Nicholson, Angela Parks-Miller, and Iltefat H Hamzavi.