Question

A 30-year-old woman presents with symmetrical joint pain, morning stiffness of 90 minutes and swelling of MCP and PIP joints. RF and anti-CCP are positive; CRP is elevated. What is the most appropriate initial disease-modifying therapy?

Accepted Answer

Methotrexate as first-line DMARD

Answer

NSAIDs alone

Answer

Low-dose prednisone monotherapy long term

Answer

Biologic agent as first-line without methotrexate

Answer

No treatment until erosions occur

Practice question

A 30-year-old woman presents with symmetrical joint pain, morning stiffness of 90 minutes and swelling of MCP and PIP joints. RF and anti-CCP are positive; CRP is elevated. What is the most appropriate initial disease-modifying therapy?