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UCTD Diagnosis — SCE Rheumatology MCQ

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HardAutoimmune SerologyUCTD DiagnosisSCE Rheumatology

An adult with autoantibody-positive SLE has persistent BILAG A skin disease and BILAG B arthritis despite adherent hydroxychloroquine and adequate trials of methotrexate and mycophenolate; repeated glucocorticoid rescue is needed. There is no active severe nephritis or CNS lupus. Which NHS escalation is specifically relevant?

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Reveal the answer and explanation

Correct answer: C — Add anifrolumab to background therapy through the NICE TA856 pathway

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

C is correct. NICE TA856 makes add-on anifrolumab relevant for inadequately controlled moderate-to-severe active autoantibody-positive SLE under its eligibility and commercial arrangements; this non-renal, non-neuropsychiatric phenotype matches the pivotal evidence. A extrapolates to severe active nephritis. B entrenches avoidable steroid harm. D ignores licensed and commissioned options. E delays steroid-sparing treatment until reversibility is lost.

Reference: NICE TA856: anifrolumab for active autoantibody-positive SLE: https://www.nice.org.uk/guidance/ta856/chapter/1-Recommendations