Axial spondyloarthritis response review — SCE Rheumatology MCQ

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ModerateSpondyloarthropathiesAxial spondyloarthritis response reviewSCE Rheumatology

A 34-year-old man started secukinumab for axial spondyloarthritis 16 weeks ago. BASDAI has improved from 7.0 to 3.2 and spinal pain VAS from 8 cm to 3 cm. He reports better sleep and no adverse effects. CRP has normalised. What is the most appropriate management?

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Correct answer: E — Continue secukinumab with routine review

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

Continue secukinumab with routine review is best because objective and symptomatic response to an approved biologic supports continuation with monitoring. A is less suitable because normal CRP alone is not a reason to stop a successful therapy; B is less suitable because methotrexate does not improve axial disease control; C is less suitable because rituximab is not used for axial spondyloarthritis; D is less suitable because long-term prednisolone is not a standard axial SpA strategy. Clinical pearl: continuation rules focus on clear evidence of response within the specified timeframe.

Reference: NICE NG65; NICE TA407