CME/CE Test

A 39-year-old man presents to his primary care provider with severe back pain. Which of the following details below would lead the clinician to consider axial spondyloarthritis (axSpA) as a differential diagnosis?

Pain is worse only after physical activity

Pain began suddenly 2 weeks prior

Pain is worse in the morning and after rest

Which of the following should be included in the regular management and assessment for patients with SpA?

Assess patient’s pain and fatigue and perform a skin examination

Palpate joints for tenderness and swelling and order a C-reactive protein (CRP)

Provide physical therapy

All of the above

The 2021 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) recommend which first-line treatment(s) for patients with axial PsA who are treatment-naive?

Tumor necrosis factor (TNF) inhibitors

Interleukin (IL)-17 inhibitors

NSAIDs

Janus kinase (JAK) inhibitor

A 35-year-old man with axSpA continues to have symptoms despite NSAIDs and physical therapy. His clinician starts him on a TNF inhibitor. When he returns at 6 months for follow up, his disease activity has not shown improvement.

According to the 2019 American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network (ACR/SAA/SPARTAN) Guidelines, which of the following drug classes/options is appropriate for his next treatment?

IL-17 inhibitor or JAK inhibitor

Biosimilar of first TNF inhibitor

Methotrexate or sulfasalazine

CME/CE Test

Virtual Case Challenges in Spondyloarthritis