Hidradenitis Suppurativa — SCE Dermatology MCQ

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ModerateDermatopharmacologyHidradenitis SuppurativaSCE Dermatology

A 32-year-old woman with hidradenitis suppurativa (HS) is being started on Adalimumab. What is the specific loading dose regimen of Adalimumab for HS (which differs from psoriasis)?

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Correct answer: A — 160 mg week 0, 80 mg week 2, then 40 mg weekly thereafter

The Adalimumab dosing regimen for hidradenitis suppurativa differs from psoriasis: HS loading dose is 160 mg at week 0 (day 1, four 40 mg injections), 80 mg at week 2, then 40 mg WEEKLY (not fortnightly as in psoriasis). This higher dose/frequency reflects the more challenging inflammatory burden in HS. Response should be assessed at 12 weeks — if no improvement, treatment should be reconsidered. NICE TA392 specifies this dosing. Adalimumab should be used alongside continued conventional management (wound care, lifestyle modification, pain management). Switching from Adalimumab to another anti-TNF is generally not recommended for HS due to limited evidence for other anti-TNFs in this indication.

Reference: NICE TA392 2016; BAD 2019 HS Guidelines