skip to main content

Belimumab Mechanism — SCE Rheumatology MCQ

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

HardRheumatology PharmacologyBelimumab MechanismSCE Rheumatology

Dermatomyositis muscle strength and CK are improving on glucocorticoid plus methotrexate, but severe active pharyngeal dysphagia persists with aspiration despite swallowing-team intervention. Which escalation is specifically supported by BSR?

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

Reveal the answer and explanation

Correct answer: A — Add intravenous immunoglobulin for treatment-resistant active dysphagia

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

B is correct. Dysphagia can remain severe despite improving limb strength or CK and carries aspiration, weight-loss and mortality risk. BSR recommends routine screening, formal swallowing assessment with speech-and-language and gastroenterology input, and consideration of IVIG when active dysphagia is resistant to other treatment. Mechanical dilatation does not treat pharyngeal myopathy, and biochemical improvement cannot safely overrule videofluoroscopic aspiration. Nutritional and airway protection proceed alongside immunomodulation.

Reference: BSR guideline on idiopathic inflammatory myopathy: https://academic.oup.com/rheumatology/article/61/5/1760/6555980