Question

A 57-year-old man with long-standing rheumatoid arthritis complains of increasing joint pain and morning stiffness despite maximum tolerated Methotrexate. There is no active infection. What is the most appropriate next step in disease-modifying treatment?

Accepted Answer

Add another conventional DMARD such as Sulfasalazine or Leflunomide in combination with Methotrexate

Answer

Add a short course of oral Prednisolone only

Answer

Stop Methotrexate and use NSAIDs alone

Answer

Switch to long-term opioid analgesia

Answer

Delay any change until joint damage is seen on X-ray

Practice question

A 57-year-old man with long-standing rheumatoid arthritis complains of increasing joint pain and morning stiffness despite maximum tolerated Methotrexate. There is no active infection. What is the most appropriate next step in disease-modifying treatment?