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ModerateRheumatologyRheumatoid Arthritisus-abimus-usmle-step-2us-usmle-step-3

A 48-year-old woman presents with symmetric swelling and pain of the metacarpophalangeal and proximal interphalangeal joints for 4 months, associated with morning stiffness lasting over one hour. Rheumatoid factor and anti-CCP antibodies are positive, and radiographs show early erosions. What is the most appropriate initial disease-modifying therapy?

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