Question

A 42-year-old woman presents with 6 months of early morning joint stiffness lasting over an hour, symmetrical swelling of the MCP and PIP joints and raised inflammatory markers. Anti-CCP antibodies are positive. According to NICE rheumatoid arthritis guidance, what is the most appropriate initial disease-modifying treatment strategy?

Accepted Answer

Start Methotrexate as a single disease-modifying drug as soon as possible, often with short-term bridging steroids.

Answer

Start Paracetamol alone for pain relief.

Answer

Delay disease-modifying treatment for 12 months to confirm the diagnosis.

Answer

Start long-term high-dose oral Prednisolone without DMARDs.

Answer

Use non-steroidal anti-inflammatory drugs only.

Practice question