Practice question

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MediumRheumatologyRheumatoid arthritisau-amcau-racp

A 58-year-old woman presents with new bilateral hand joint pain and morning stiffness lasting more than an hour. Examination shows swollen, tender MCP and PIP joints. Rheumatoid factor and anti-CCP antibodies are positive. According to RA management principles, what is the most appropriate initial disease-modifying therapy?

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