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MS – Psychological Interventions — SCE Neurology MCQ

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HardNeuropsychiatryMS – Psychological InterventionsSCE Neurology

A patient taking dimethyl fumarate has remained clinically and radiologically stable, but lymphocytes have been 0.61–0.73×10^9/L at 3-month checks for 9 months. Which action best matches the SmPC?

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Correct answer: E — Reassess dimethyl-fumarate benefit and PML risk; mandatory discontinuation does not yet apply

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

B is correct. Sustained moderate lymphopenia from 0.5 to below 0.8×10^9/L for more than six months requires explicit benefit-risk reassessment and closer PML-risk consideration. A incorrectly applies the severe-lymphopenia rule. C removes necessary monitoring. D is not an authorised treatment for this drug effect. E mistakes stability for inadequate treatment and ignores immune risk.

Reference: Tecfidera 240 mg — SmPC: https://www.medicines.org.uk/emc/product/10096/smpc