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IL-6 Inhibitor Monitoring — SCE Rheumatology MCQ

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ModerateRheumatology PharmacologyIL-6 Inhibitor MonitoringSCE Rheumatology

A patient with RA is being switched from oral Methotrexate to Sarilumab (anti-IL-6 receptor monoclonal antibody) after failing multiple treatments. What monitoring consideration specific to IL-6 inhibitors is required?

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Correct answer: B — Blood, liver, lipid and GI monitoring

IL-6 receptor inhibitors (Tocilizumab, Sarilumab) require specific monitoring beyond standard biologic therapy: neutrophil counts (IL-6 blockade can cause dose-dependent neutropenia), liver function (hepatotoxicity), lipid profiles (IL-6 blockade increases LDL), and awareness of diverticular perforation risk (masked presentation due to suppressed inflammatory response). CRP is unreliable for infection monitoring. BSR biologic safety guidelines recommend FBC, LFTs, and lipids at baseline and during treatment with IL-6 inhibitors.

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