A 58-year-old woman with long-standing rheumatoid arthritis has persistent synovitis of multiple joints despite regular NSAID use. According to Canadian Rheumatology Association guidelines, what is the next most appropriate step?AContinue NSAIDs only and monitor annuallyBStart a conventional synthetic disease-modifying antirheumatic drug such as methotrexateCStart long-term high-dose oral prednisone without DMARDsDUse opioids for chronic pain control as primary therapyEDelay treatment until radiographic erosions appearCheck my answer