A 45-year-old with newly diagnosed rheumatoid arthritis has active symmetric synovitis of multiple MCP and PIP joints, elevated inflammatory markers,

Question

A 45-year-old with newly diagnosed rheumatoid arthritis has active symmetric synovitis of multiple MCP and PIP joints, elevated inflammatory markers, and no prior disease-modifying therapy. Which initial disease-modifying strategy is preferred?

Accepted Answer

Start methotrexate monotherapy with folate and laboratory monitoring

Answer

Start hydroxychloroquine monotherapy with symptom-based follow-up

Answer

Start long-term glucocorticoid monotherapy with symptom-based follow-up

Answer

Start a biologic agent before conventional DMARD treatment

Answer

Start sulfasalazine monotherapy with symptom-based follow-up

Adult Still disease — ABIM Board MCQ

A 45-year-old with newly diagnosed rheumatoid arthritis has active symmetric synovitis of multiple MCP and PIP joints, elevated inflammatory markers, and no prior disease-modifying therapy. Which initial disease-modifying strategy is preferred?