Rheumatology

Question 1

What are the side effects of the biologic DMARD tociluzmab?

Answer 1

Bowel perforation / diverticulitis

Supressed CRP when septic

Infection

Question 2

What are the side effects of the biologic DMARDs TNFi?

Answer 2

Drug induced SLE

Demyelination

ILD

Lymphoma

Infection (TB, HepB/C, Zoster)

Heart failure—contraindicated in moderate or severe heart failure (NYHA class III–IV) and left ventricular ejection fraction <50%

Question 3

What are the adverse effects of the biological DMARD rituximab?

Answer 3

PML

Infection

Question 4

What are the side effects of the targeted synthetic DMARDs such as the Janus Kinase inhibitors?

Answer 4

Thrombus

Infection including herpes zoster reactivation

Question 5

What are the side effects of the conventional DMARD MTX?

Answer 5

Pancytopenia

LFT derangement

Pulmonary fibrosis

Ulcers

Hair loss

Question 6

What are the side effects of the conventional DMARD leflunomide?

Answer 6

Similar to MTX (pancytopenia, LFT, pulmonary fibrosis) but also diarrhoea and neuropathy.

Half life is 2-4 weeks!

Rx of toxicity = charcoal or cholestyramine

Question 7

What are the side effects of the conventional DMARD sulfasalazine?

Answer 7

reversible male infertility (oligospermia)

rash

pancreatitis

hepatitis