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Rheumatoid Arthritis — SCE Rheumatology MCQ

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HardRheumatoid ArthritisRheumatoid ArthritisSCE Rheumatology

A patient with rheumatoid arthritis has failed two TNF inhibitors and has recurrent serious respiratory infections with bronchiectasis. Which principle should guide the next advanced therapy?

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Correct answer: D — Use a non-TNF option after immunology and infection-risk review

Recurrent serious infection and bronchiectasis require multidisciplinary review of immunoglobulins, colonisation, vaccination and prophylaxis before further immunosuppression. A non-TNF mechanism may be preferred, but one named drug cannot be selected without the full comorbidity profile.

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