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Rheumatoid arthritis shared care — SCE Rheumatology MCQ

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EasyInflammatory ArthritisRheumatoid arthritis shared careSCE Rheumatology

A 50-year-old woman with rheumatoid arthritis is stable on sulfasalazine prescribed through shared care. Her GP asks what arrangement should be in place before continuing repeat prescriptions. The patient has no adverse effects and blood monitoring has been normal. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Use an agreed shared-care protocol with defined monitoring responsibilities

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

Use an agreed shared-care protocol with defined monitoring responsibilities is best because csDMARD prescribing in shared care should have clear responsibilities for monitoring, dose changes and communication. A is less suitable because discharge without monitoring risks missed toxicity; B is less suitable because stopping treatment after symptom improvement risks relapse; C is less suitable because patient-led dose changes are unsafe without clinician review; E is less suitable because toxicity monitoring is routine and not limited to flares. Clinical pearl: shared care is a governance requirement as much as a prescribing convenience.

Reference: BSR csDMARD guideline 2025; BNF