Leveraging Immunologic Pathways in the Management of Patients With Psoriatic Arthritis or Axial Spondylarthritis: Clinical Pearls for the Advanced Practice Provider
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Which of the following is the most reliable indicator for identifying active disease in patients with psoriatic arthritis (PsA)?
Elevated C-reactive protein (CRP) levels
Presence of dactylitis
Normal erythrocyte sedimentation rate (ESR)
Patient-reported joint pain
A 35-year-old man with psoriatic arthritis (PsA) has failed treatment with methotrexate and shows inadequate response to a TNF inhibitor. According to the latest treatment guidelines, which of the following would be the most appropriate next step in his treatment?
Switch to another TNF inhibitor
Add sulfasalazine to the current regimen
Switch to an IL-17 inhibitor
Start apremilast
How often should you reassess disease activity and consider treatment adjustment when using a treat-to-target approach for axial spondyloarthritis (axSpA)?
Every 2-4 weeks
Every 3-4 months
Every 6 months
Annually
Sarah, a 28-year-old woman, presents with a 3-year history of low back pain, morning stiffness lasting 1 hour, and occasional heel pain. She was recently diagnosed with axial spondyloarthritis. Initial treatment with NSAIDs provided minimal relief. Her BASDAI score is 5.2 and MRI shows active inflammation in the sacroiliac joints. Her CRP is mildly elevated at 15 mg/L. Which of the following is the most appropriate next step in Sarah's management?
Continue NSAIDs and reassess in 6 months
Start methotrexate and reassess in 3 months
Initiate a TNF inhibitor and reassess in 3 months
Start sulfasalazine and reassess in 2 months
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