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NBME Free 120 Answers

free120/Block 3/Question#15 (reveal difficulty score)
A 46-year-old woman with active ankylosing ...
Tumor necrosis factor ฮฑ ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: pharm Immuno

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 +6  upvote downvote
submitted by โˆ—em_goldman(30)

Rituximab (anti-CD 20) is currently undergoing trials for AS. My sparse googling just now shows that rituximab probably only has a moderate effect, so probably second-line to anti-TNFa therapy. Probably.

Safe to say for boards that AS: TNFa > CD20

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cheesetouch  FA 2018 - rituximab p 430 -- - use for Nonhodgkins lymphoma, CLL, ITP, Rheumatoid arthritis TNF-a inhibitors - p 472: 1) etanercept for Ra, psoriasis, ankylosing spondylitis. 2) infliximab and other mAB for IBD, RA, AS, psoriasis +3

 +2  upvote downvote
submitted by โˆ—osler_weber_rendu(160)

Monoclonal Antibodies are always last resort! I just use this as a general rule

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submitted by โˆ—bwdc(697)

Many autoimmune/autoinflammatory conditions, including ankylosing spondylitis, are treated with DMARDs like anti-TNF-alpha medications when milder stuff doesnโ€™t do the trick. Common examples are infliximab (Remicade) and adalimumab (Humira).

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