A highly selected patient receives canakinumab 150 mg for a severe gout attack because NSAIDs, colchicine and repeated corticosteroids are

Question

A highly selected patient receives canakinumab 150 mg for a severe gout attack because NSAIDs, colchicine and repeated corticosteroids are unsuitable. At 72 hours there has been no meaningful clinical response. What is the labelled next principle?

Accepted Answer

Withhold further canakinumab and reassess the diagnosis and management plan

Answer

Repeat canakinumab 150 mg after 7 days and review at day 14

Answer

Begin canakinumab 150 mg monthly and continue for six months

Answer

Add a TNF inhibitor after completing latent-tuberculosis screening

Answer

Escalate canakinumab to 300 mg after 72 hours and optimise urate lowering

DETECT Algorithm SSc-PAH — SCE Rheumatology MCQ

A highly selected patient receives canakinumab 150 mg for a severe gout attack because NSAIDs, colchicine and repeated corticosteroids are unsuitable. At 72 hours there has been no meaningful clinical response. What is the labelled next principle?