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Axial spondyloarthritis — SCE Rheumatology MCQ

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ModerateSpondyloarthropathiesAxial spondyloarthritisSCE Rheumatology

A 31-year-old man with axial spondyloarthritis has active inflammatory back pain despite exercise and two adequate NSAID trials. Examination shows BASDAI remains high and CRP is raised. Investigations show MRI shows active sacroiliitis. What is the most appropriate management?

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Correct answer: B — Advanced-therapy assessment

Persistent active axial spondyloarthritis despite NSAIDs and physiotherapy warrants assessment for biologic or targeted synthetic therapy. Methotrexate is not effective for predominant axial disease. Objective inflammation, symptoms and function are used together when deciding eligibility and response.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/musculoskeletal-conditions