Mrs Wong, a 54 year old secretary was diagnosed to have rheumatoid arthritis. She was prescribed two conventional synthetic disease modifying anti-rheumatic drugs (scDMARDs) by her rheumatologist. Six months after, the disease was not under control. Mrs Wong visited her rheumatologist again. She was advised to use a biologic agent for the treatment of her rheumatoid arthritis.

a) Name FOUR first line csDMARDs for the treatment of rheumatoid arthritis (4 marks)

b) Name TWO specific side effects of each csDMARD you have described (8 marks)

c) Name FOUR classes of biologic agents licensed for the treatment of RA ( 4 marks)

d) Name ONE agent for each class of biologic agent you have described and its route of administration (4 marks)