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SpA with IBD Treatment Choice — SCE Rheumatology MCQ

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HardSpondyloarthropathySpA with IBD Treatment ChoiceSCE Rheumatology

A patient with active axial spondyloarthritis also has moderately active Crohn disease and recurrent anterior uveitis. Which targeted therapy offers the most coherent cross-domain choice?

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Correct answer: D — Use a monoclonal TNF inhibitor such as adalimumab or infliximab

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

C is correct. A monoclonal TNF antibody can treat axial SpA, Crohn disease and uveitis. A is unsuitable because etanercept lacks reliable IBD efficacy. B is unsuitable because IL-17 inhibition can aggravate active IBD. D is wrong because apremilast is not an established treatment for axial disease or Crohn disease. E treats Crohn disease but has not demonstrated the necessary axial efficacy. Gastroenterology and ophthalmology input still informs product choice.

Reference: BSR 2025 axial-spondyloarthritis biologic and targeted-DMARD guideline: https://academic.oup.com/rheumatology/article/64/6/3234/8108017