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IL-6 inhibitor monitoring — SCE Rheumatology MCQ

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HardRheumatological pharmacologyIL-6 inhibitor monitoringSCE Rheumatology

A 50-year-old woman on sarilumab for RA has good joint control. Monitoring bloods show neutrophils 0.7 × 10^9/L, ALT 92 IU/L and fasting cholesterol has risen. She is asymptomatic and CRP is undetectable. What is the most appropriate management?

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Correct answer: E — Withhold treatment and manage according to IL-6 inhibitor monitoring thresholds

IL-6 inhibitors require monitoring for neutropenia, liver enzyme abnormalities and lipids; CRP suppression does not indicate drug safety. Significant neutropenia should prompt withholding and review according to product guidance and shared-care protocols. Lipid monitoring and cardiovascular risk management are also needed.

Reference: BNF; BSR biologic DMARD safety guideline