Axial spondyloarthritis with uveitis — SCE Rheumatology MCQ

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HardSpondyloarthropathiesAxial spondyloarthritis with uveitisSCE Rheumatology

A 35-year-old man has recurrent anterior uveitis despite active axial disease after NSAID trials. Examination shows limited spinal movement and enthesitis. Investigations show infection screening is negative. What is the most appropriate biologic?

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Correct answer: C — Adalimumab

The best answer is “Adalimumab”. Adalimumab is the most appropriate next step after the disease phenotype, previous treatment and safety constraints in the stem are considered. The remaining choices—“Etanercept, after specialist assessment”, “Tocilizumab, with clinical reassessment”, “Anakinra, after safety review”, “Rituximab, after specialist assessment”—are credible in related rheumatology presentations, but each addresses a different diagnosis, investigation, treatment sequence or complication and does not fit the decisive findings in this stem.

Reference: NICE NG65 spondyloarthritis: https://www.nice.org.uk/guidance/ng65/chapter/Recommendations