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MediumRheumatologyRheumatoid arthritisca-rcpsc-imca-mccqe1

A 50-year-old woman has 6 months of symmetrical pain and swelling in the MCP and PIP joints with morning stiffness of 90 minutes. Rheumatoid factor and anti-CCP antibodies are positive. According to the Canadian Rheumatology Association living guidelines, which is the preferred initial disease-modifying therapy in the absence of contraindications?

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