A 62-year-old man with long-standing rheumatoid arthritis has persistent synovitis in multiple joints despite optimal NSAID use. According to modern RA management, what is the most appropriate next step?AContinue NSAIDs onlyBStart a conventional synthetic DMARD such as methotrexate and refer to rheumatology earlyCUse long-term systemic glucocorticoids aloneDDelay DMARDs until radiographic damage is evidentETreat with opioids for chronic pain onlyCheck my answer