A 59-year-old woman with long-standing rheumatoid arthritis presents with persistent synovitis despite intermittent NSAID use. She has erosive changes...

Question

A 59-year-old woman with long-standing rheumatoid arthritis presents with persistent synovitis despite intermittent NSAID use. She has erosive changes on hand radiographs. According to typical Canadian rheumatology practice based on international RA guidelines, what is the preferred initial disease-modifying treatment?

Accepted Answer

Methotrexate as a conventional synthetic DMARD

Answer

Low-dose prednisone monotherapy

Answer

Hydroxychloroquine monotherapy indefinitely

Answer

Biologic TNF inhibitor as first-line

Answer

Analgesics only with no DMARDs

ca-mccqe1 MCQ (SBA): Rheumatoid arthritis