MediumRheumatologyRheumatoid arthritis escalation to biologic therapyau-amcau-racp
A 49‑year‑old woman has long‑standing seropositive rheumatoid arthritis with persistent synovitis of the hands and wrists despite maximal doses of methotrexate and hydroxychloroquine. She has normal renal and liver function and no active infection. According to current practice, what is the most appropriate next step?