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NPWT Contraindications — SCE Dermatology MCQ

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HardWound HealingNPWT ContraindicationsSCE Dermatology

An adult with active moderate-to-severe hidradenitis suppurativa has failed prolonged oral antibiotics and adalimumab. Secukinumab is started. At week 16, abscess and inflammatory-nodule count falls from 16 to 11, with no new abscesses or draining fistulas. What does NICE TA935 advise?

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Correct answer: E — Continue secukinumab because the NICE week-16 response threshold is met

Explanation lettering: D = shown as A · C = shown as B · B = shown as C · A = shown as D

E is correct. The count has fallen by 5 of 16, a 31.25% reduction, and there is no increase in abscesses or draining fistulas. NICE continues secukinumab after week 16 when total abscess and inflammatory-nodule count falls by at least 25% without either worsening component. TA935 specifically positions treatment after conventional systemic therapy when adalimumab is unsuitable, ineffective or has stopped working. The rule is not HiSCR50 and does not require all fistulas to close. Pain, quality of life and adverse effects remain relevant alongside the formal continuation threshold.

Reference: NICE TA935: secukinumab for moderate-to-severe hidradenitis suppurativa: https://www.nice.org.uk/guidance/ta935/chapter/1-Recommendations