Which therapeutic approach is indicated for enteropathic arthritis according to the source?

• A. IL-23 and TNF inhibitors are used
• B. Only NSAIDs are used
• C. Surgery is the only treatment
• D. Antibiotics are first-line

Answer: (A)

Enteropathic arthritis responds best to systemic immunomodulation that targets the inflammatory pathways shared by the gut and joints. Blocking TNF-alpha has strong evidence for improving both intestinal inflammation (inflammatory bowel disease) and joint symptoms, making anti-TNF therapies a mainstay. Adding IL-23 pathway inhibition is also effective because IL-23 drives the Th17 inflammatory axis involved in mucosal and joint disease; IL-12/23 inhibitors used in IBD can help with arthritis as well. Together, therapies that inhibit TNF and IL-23 address the underlying inflammatory processes driving the condition.

NSAIDs alone often fail to control the arthritis and can worsen gut disease, surgery is not a primary treatment for the inflammatory arthritis, and antibiotics are not a first-line strategy for this condition.