Question

A 45-year-old woman presents with symmetric pain and swelling in the small joints of her hands and morning stiffness >1 hour for 3 months. RF and anti-CCP are positive; ESR is elevated. According to Canadian rheumatology guidance, what is the most appropriate initial disease-modifying treatment?

Accepted Answer

Methotrexate as first-line DMARD

Answer

NSAIDs alone for symptomatic relief

Answer

Low-dose prednisone alone

Answer

Biologic agent as first-line in all patients

Answer

No treatment until radiographic erosions appear

Practice question

A 45-year-old woman presents with symmetric pain and swelling in the small joints of her hands and morning stiffness >1 hour for 3 months. RF and anti-CCP are positive; ESR is elevated. According to Canadian rheumatology guidance, what is the most appropriate initial disease-modifying treatment?