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MediumRheumatologyRheumatoid arthritis treatment escalationca-mccqe1ca-rcpsc-im

A 62-year-old woman with long-standing rheumatoid arthritis presents with morning stiffness, small joint swelling and elevated inflammatory markers despite methotrexate at 25 mg weekly and folic acid. According to Canadian RA management guidelines, what is the next best step?

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