A 58-year-old woman with rheumatoid arthritis presents with early morning stiffness lasting 2 hours and symmetrical swelling of MCP and PIP joints for...

Question

A 58-year-old woman with rheumatoid arthritis presents with early morning stiffness lasting 2 hours and symmetrical swelling of MCP and PIP joints for 4 months. RF and anti-CCP antibodies are positive, and X-rays show no erosions. According to Canadian rheumatology guidance, what is the most appropriate initial disease-modifying treatment?

Accepted Answer

Methotrexate as first-line DMARD

Answer

Non-steroidal anti-inflammatory drugs alone

Answer

Low-dose oral prednisone for long-term monotherapy

Answer

Biologic agent as first-line therapy in all patients

Answer

No DMARD therapy until erosions appear

ca-mccqe1 MCQ (SBA): Rheumatoid arthritis initial management