A 40-year-old woman presents with polyarthralgia, morning stiffness 1 hour, and symmetrical swelling of MCP and PIP joints. ESR and CRP are elevated,...

Question

A 40-year-old woman presents with polyarthralgia, morning stiffness >1 hour, and symmetrical swelling of MCP and PIP joints. ESR and CRP are elevated, and rheumatoid factor and anti-CCP antibodies are positive. According to Canadian rheumatology guidelines, what is the initial disease-modifying pharmacotherapy of choice?

Accepted Answer

Methotrexate as first-line DMARD unless contraindicated

Answer

Hydroxychloroquine monotherapy in all cases

Answer

Long-term high-dose glucocorticoids only

Answer

Biologic agent as first-line in all patients

Answer

NSAIDs alone

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