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Hidradenitis Suppurativa (HS) is a skin condition causing deep, painful bumps that appear where skin rubs together. These bumps can swell, become red, and sometimes fill with pus, turning into abscesses that may burst. Over time, HS can lead to scars and tunnels on or under the skin. This study aims to evaluate how safe and effective the drug zasocitinib is for adults with moderate to severe HS, comparing it to a placebo in a Phase 2 trial. Participants will receive either zasocitinib or a placebo capsule daily for 16 weeks. The placebo looks the same but contains no medicine. After this initial 4-month period, all participants, including those who first received placebo, will be offered zasocitinib for up to an additional 8 months. Throughout the study, participants will visit the clinic 12 times for treatment and monitoring. During the visits, researchers will assess treatment response, including the percentage of participants achieving a 75% reduction in HS signs at week 16. They will also monitor safety and tolerance of the medication. Participants will undergo various evaluations such as physical exams, lab tests, and questionnaires to track disease progress and side effects. The study includes careful follow-up to ensure participant safety and to gather detailed information on the drug's effects over the total study duration of up to 12 months.