Biologic Response Assessment — SCE Rheumatology MCQ

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

EasyRheumatoid ArthritisBiologic Response AssessmentSCE Rheumatology

A 42-year-old woman has severe active rheumatoid arthritis despite intensive combination conventional DMARD therapy, including methotrexate. Adalimumab is started in combination with methotrexate. According to NICE criteria, at what time point should her EULAR response be assessed to determine whether adalimumab may be continued?

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

Reveal the answer and explanation

Correct answer: D — 6 months

The correct answer is **B, 6 months**. NICE specifies that a biological DMARD should be continued only if at least a moderate EULAR response is present at 6 months; treatment should subsequently be stopped if that response is not maintained. This continuation decision is distinct from routine treat-to-target monitoring: CRP and composite disease activity should be measured monthly while rheumatoid arthritis remains active. It is also distinct from the adalimumab SmPC statement that response is usually apparent within 12 weeks and that therapy should be reconsidered if there has been no response by then, making 3 months a plausible but incorrect answer to this specifically worded question. Two weeks is too early for the NICE continuation decision, while 12 and 24 months would delay assessment excessively.

Reference: National Institute for Health and Care Excellence. Rheumatoid arthritis in adults: management (NG100), recommendation 1.9.3, amended 2024. https://www.nice.org.uk/guidance/ng100/chapter/Recommendations