Question

A 47-year-old woman with a history of rheumatoid arthritis presents with early morning stiffness lasting over an hour and swelling of the small joints of her hands for several months. RF and anti-CCP are positive. What is the most appropriate initial disease-modifying treatment?

Accepted Answer

Start Methotrexate as first-line DMARD with appropriate monitoring

Answer

Long-term high-dose oral Prednisolone monotherapy

Answer

Start Hydroxychloroquine only

Answer

Prescribe NSAIDs alone for symptomatic relief

Answer

Refer only when joint deformities develop

Practice question

A 47-year-old woman with a history of rheumatoid arthritis presents with early morning stiffness lasting over an hour and swelling of the small joints of her hands for several months. RF and anti-CCP are positive. What is the most appropriate initial disease-modifying treatment?