Systemic Sclerosis — SCE Rheumatology MCQ

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HardSystemic SclerosisSystemic SclerosisSCE Rheumatology

A 55-year-old woman with SSc on long-term Nifedipine for Raynaud develops recurrent digital ulcers. She has had 4 new ulcers in the past 12 months despite Nifedipine. According to BSR 2024, which agent is specifically recommended for PREVENTION of new digital ulcers?

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Correct answer: A — Bosentan

The best answer is “Bosentan”. Bosentan is supported by the cited UK or directly applicable specialist authority and best matches the tested threshold, complication or monitoring principle. The remaining choices—“Fluoxetine, after safety review”, “IV Iloprost, after specialist assessment”, “Aspirin, with clinical reassessment”, “Sildenafil, after safety review”—are credible in related rheumatology presentations, but each addresses a different diagnosis, investigation, treatment sequence or complication and does not fit the decisive findings in this stem.

Reference: BSR 2024 systemic sclerosis guideline: https://pmc.ncbi.nlm.nih.gov/articles/PMC11534099/