skip to main content

RA QRISK3 Adjustment — SCE Rheumatology MCQ

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

ModerateRheumatoid ArthritisRA QRISK3 AdjustmentSCE Rheumatology

A 60-year-old woman with RA on Methotrexate and Prednisolone 5 mg daily attends for annual review. Her QRISK3 score is 15%. Applying the EULAR 1.5x multiplication factor what is her adjusted cardiovascular risk and what treatment implications does this have?

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

Reveal the answer and explanation

Correct answer: D — Her adjusted risk is 22.5% (15% × 1.5) which exceeds the 20% NICE threshold for statin therapy; she should be offered atorvastatin 20 mg and aggressive risk factor management

EULAR 2015/2016 cardiovascular risk management recommendations advise multiplying the calculated cardiovascular risk score by 1.5 for RA patients to account for disease-related excess cardiovascular risk. This patient's QRISK3 of 15% × 1.5 = 22.5% adjusted risk exceeds the NICE 20% threshold for statin initiation. While QRISK3 does include RA as a risk factor it may not fully capture the inflammatory contribution to cardiovascular risk hence the EULAR recommendation for the 1.5 multiplier. This adjusted risk should trigger: statin initiation (Atorvastatin 20 mg) blood pressure optimisation smoking cessation support diabetes screening and glucocorticoid dose minimisation.

Reference: EULAR 2015 CV risk management; NICE CG181 cardiovascular risk