18th January 2024

A 33-year-old pharmacist has been referred to the Rheumatology outpatient clinic due to a 4-month history of pain and swelling affecting her knuckles and wrists.

A 33-year-old pharmacist has been referred to the Rheumatology outpatient clinic due to a 4-month history of pain and swelling affecting her knuckles and wrists. She has a family history of RA on the maternal side of her family. Examination is consistent with inflammatory synovitis. A diagnosis of RA is made, and the consultant wants to start her on early DMARD therapy. The patient is anxious about this as she is planning on starting a family and is aware that some DMARDs can be harmful to the baby. Which of the following drugs should the patient be started on?  

Select the SINGLE most appropriate option from the list below. Select ONE option only.