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focuSSed Trial Results — SCE Rheumatology MCQ

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HardSystemic SclerosisfocuSSed Trial ResultsSCE Rheumatology

A patient has early diffuse cutaneous systemic sclerosis, anti-topoisomerase-I positivity, raised inflammatory markers and early ILD. Tocilizumab is discussed. Which statement most accurately represents the evidence used by BSR?

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Correct answer: C — Skin endpoint negative; FVC preservation supports use in selected early inflammatory diffuse disease

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

E is correct. In focuSSced the modified Rodnan skin-score primary endpoint was not met, but lung-function preservation generated support for tocilizumab in selected early inflammatory diffuse SSc, particularly with poor-prognosis markers and ILD risk. A overstates phenotype and reversibility. B assigns an unproven renal-crisis prevention effect. C reverses the trial result. D invents a transplant-only restriction.

Reference: BSR systemic sclerosis guideline 2024: https://academic.oup.com/rheumatology/article/63/11/2956/7750184