Rheumatoid Arthritis — SCE Rheumatology MCQ

Instant feedback + full explanation. One question, done properly.

EasyRheumatoid ArthritisRheumatoid ArthritisSCE Rheumatology

A 60-year-old woman with RA on Methotrexate and Adalimumab requires a hip replacement. When should Adalimumab be withheld perioperatively?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Withhold for one dosing cycle before surgery

BSR biologic safety guidelines recommend withholding biologic therapy for one dosing interval before elective surgery and restarting when wound healing is satisfactory and there is no evidence of infection. For Adalimumab (given every 2 weeks), this means omitting the dose immediately before surgery. Methotrexate can generally be continued perioperatively. Permanent discontinuation is not indicated.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/musculoskeletal-conditions