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Relapsing polychondritis — SCE Rheumatology MCQ

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HardPregnancy and rare rheumatic diseaseRelapsing polychondritisSCE Rheumatology

A patient receiving tocilizumab for rheumatoid arthritis has an absolute neutrophil count of 0.7 ×10^9/L on repeat testing, no fever and normal platelets. What is the product-specific action?

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

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Correct answer: A — Tocilizumab hold pending the SmPC neutrophil recovery threshold

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

D is correct. Tocilizumab dosing is interrupted when neutrophils fall into the SmPC hold range; treatment can be resumed only after recovery to the specified threshold, with route-specific dose or frequency adjustment. A treats absence of fever as laboratory safety. B introduces routine G-CSF unsupported by the product guidance. C converts a reversible hold into indiscriminate permanent cessation. E states the correct principle: verify the count, assess infection and other causes, hold the IL-6 inhibitor, and follow the product-specific restart table rather than an invented universal DMARD rule.

Reference: UK RoActemra summary of product characteristics: https://www.medicines.org.uk/emc/product/6673/smpc