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A 50-year-old woman presents to the rheumatology clinic due to an 8-month history of joint pain and swelling that affects her bilateral wrists, MCP, and PIP joints. She also complains of morning stiffness that usually lasts more than one hour. On examination, there’s swelling and tenderness in her wrists, MCP, and PIP joints. Laboratory tests show elevated ESR and CRP levels along with positive rheumatoid factor and anti-CCP antibodies.


What is the most appropriate first-line disease-modifying treatment for this patient?

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