skip to main content

SpA Uveitis Prevention — SCE Rheumatology MCQ

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

ModerateSpondyloarthropathySpA Uveitis PreventionSCE Rheumatology

A 30-year-old man with radiographic axial spondyloarthritis is receiving etanercept. He has had three episodes of ophthalmologist-confirmed acute anterior uveitis in the past 18 months, including a current episode receiving standard ophthalmic treatment. Which rheumatological treatment strategy is most appropriate to reduce the risk of further uveitis episodes?

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

Reveal the answer and explanation

Correct answer: A — Switch etanercept to a monoclonal TNF inhibitor

A monoclonal TNF inhibitor is preferred when recurrent anterior uveitis influences biologic selection in axial spondyloarthritis. Relevant agents include adalimumab, infliximab, golimumab and certolizumab pegol, subject to individual licensing, commissioning and contraindications. Etanercept is not the preferred TNF inhibitor for preventing recurrent uveitis, so continuing it is inappropriate when recurrence is the decisive issue. IL-17 inhibitors are effective for axial disease but are not preferred for recurrent uveitis. Continuous topical corticosteroids are not routine prophylaxis and carry important ocular toxicity risks; acute episodes require ophthalmology-led treatment. Sulfasalazine is not an appropriate substitute for biologic treatment of active axial disease and is not the recommended strategy for this scenario.

Reference: British Society for Rheumatology. The 2025 British Society for Rheumatology guideline for the treatment of axial spondyloarthritis with biologic and targeted synthetic DMARDs, 2025. https://pubmed.ncbi.nlm.nih.gov/40199504/