skip to main content

Systemic Sclerosis — SCE Rheumatology MCQ

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

HardSystemic SclerosisSystemic SclerosisSCE Rheumatology

A 45-year-old woman with diffuse cutaneous systemic sclerosis and anti-topoisomerase I (Scl-70) antibody positivity has progressive skin thickening and new cough. HRCT shows ground-glass changes in the lower lobes. PFTs show FVC 68% predicted and DLCO 55% predicted. According to BSR 2024, what is the first-line treatment for SSc-ILD?

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

Reveal the answer and explanation

Correct answer: B — Mycophenolate mofetil

BSR 2024 SSc guidelines recommend Mycophenolate mofetil as first-line treatment for SSc-associated interstitial lung disease. Rituximab and/or IV Cyclophosphamide may be used as alternatives. Tocilizumab should be considered as first-line in early diffuse SSc with raised inflammatory markers and anti-topoisomerase I positivity, independent of ILD status. Nintedanib is an anti-fibrotic that may be added to immunosuppression for progressive ILD but is not first-line monotherapy.

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