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Pre-Biologic Screening — SCE Rheumatology MCQ

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

HardRheumatology PharmacologyPre-Biologic ScreeningSCE Rheumatology

A patient with GPA is in remission on avacopan-containing therapy and must start rifampicin for drug-susceptible tuberculosis. Which interaction plan is most consistent with the UK SmPC?

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

Reveal the answer and explanation

Correct answer: C — Use an alternative to rifampicin or avacopan before treatment begins

Explanation lettering: E = shown as A · A = shown as B · B = shown as E

C is correct. Rifampicin is a strong CYP3A4 inducer and reduced avacopan AUC by about 93% and peak concentration by about 79% in the interaction study. Long-term strong induction is therefore to be avoided because efficacy may be lost. Dose separation cannot overcome enzyme induction, and neither dose escalation nor once-daily schedules are authorised compensation strategies.

Reference: Avacopan Vifor 10 mg hard capsules SmPC: https://www.medicines.org.uk/emc/product/13744/smpc