A 58-year-old woman with long-standing rheumatoid arthritis treated with methotrexate presents with increasing joint pain and prolonged morning stiffn...

Question

A 58-year-old woman with long-standing rheumatoid arthritis treated with methotrexate presents with increasing joint pain and prolonged morning stiffness. She has swelling in the MCP and PIP joints bilaterally. According to Canadian RA guidelines, what is the next step in management?

Accepted Answer

Escalate therapy by adding or switching to a biologic or targeted synthetic DMARD in consultation with rheumatology

Answer

Increase NSAIDs and continue current methotrexate dose

Answer

Switch methotrexate to hydroxychloroquine monotherapy

Answer

Stop all DMARDs and observe

Answer

Use chronic high-dose glucocorticoids instead of DMARDs

ca-mccqe1 MCQ (SBA): Rheumatoid arthritis treat-to-target escalation

A 58-year-old woman with long-standing rheumatoid arthritis treated with methotrexate presents with increasing joint pain and prolonged morning stiffness. She has swelling in the MCP and PIP joints bilaterally. According to Canadian RA guidelines, what is the next step in management?