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Nail-Enthesis Connection PsA — SCE Rheumatology MCQ

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HardSpondyloarthropathyNail-Enthesis Connection PsASCE Rheumatology

A patient with psoriatic arthritis has severe plaque psoriasis, recurrent anterior uveitis and active Crohn disease. Peripheral arthritis remains active after methotrexate. Which advanced-therapy family most coherently satisfies all three extra-musculoskeletal constraints?

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Correct answer: E — A monoclonal TNF inhibitor with established efficacy across Crohn disease and recurrent uveitis

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

A is correct. A monoclonal anti-TNF can address joints and skin, is preferred for recurrent uveitis and is an accepted IBD therapy. B lacks comparable efficacy for uveitis and Crohn disease. C risks exacerbating active IBD. D is not the preferred mechanism for substantial skin disease. E does not reliably control uveitis or moderate-to-severe Crohn disease.

Reference: EULAR recommendations for PsA pharmacological treatment 2023: https://ard.bmj.com/content/83/6/706