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Biologic safety — SCE Rheumatology MCQ

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HardRheumatological pharmacologyBiologic safetySCE Rheumatology

A patient taking secukinumab for axial spondyloarthritis develops bloody diarrhoea, weight loss and colonoscopic Crohn disease. Infection has been excluded. What is the correct medicine action?

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

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Correct answer: D — Discontinue secukinumab and refer for Crohn-disease treatment

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

C is correct. The secukinumab SmPC states that it is not recommended in IBD and should be discontinued when new IBD develops or pre-existing disease exacerbates. IL-17 blockade can worsen intestinal inflammation, so dose escalation, automatic rechallenge or within-class switching is inappropriate. Subsequent therapy should be selected jointly for axial and bowel disease.

Reference: Secukinumab UK SmPC. https://www.medicines.org.uk/emc/product/12953/smpc