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Anti-TNF Choice for SpA Uveitis — RACP Adult Medicine MCQ

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HardRheumatologyAnti-TNF Choice for SpA UveitisRACP Adult Medicine

A patient with axial spondyloarthritis has recurrent anterior uveitis despite good spinal control on etanercept. Which biologic change is preferred?

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Correct answer: E — Switch to a monoclonal anti-TNF agent with evidence for reducing uveitis recurrence

The best answer is “Switch to a monoclonal anti-TNF agent with evidence for reducing uveitis recurrence”. Monoclonal TNF inhibitors such as adalimumab or infliximab reduce recurrent uveitis more reliably than the soluble-receptor agent etanercept. Ophthalmic corticosteroid treats the acute episode, but frequent recurrence should influence systemic therapy. Choice also considers psoriasis, IBD, infection risk and previous biologic response.

Reference: Australian Rheumatology Association: Biologic medicines: https://rheumatology.org.au/For-Patients/Adult-Medication-Information