<prompt> A female repos symmetrical small joint polyahritis for 2 weeks. Labs show rheumatoid factor levels at 1:320 positive is 1:40 and anti-CCP at 58 units 40 to 59 units are considered strongly positive. An antinuclear antibody test is negative. Labs also reveal positive cytomegalovirus and paravovirus IgG, and negative parvovirus IgM. The ESR is 62 mmhour. What is the appropriate next step in the management of this patient?Naproxen 500 mg twice a day and follow up in 1 monthMethotrexate 12.5 mg a week with liver function tests in 1 monthAnti-histone antibodies, anti-DS-DNA, and complement levelsPrednisone 60 mg a day and follow up in 2 weeks  <response>: It is a Dx of RA Option A: Naproxen not recommended, straight away sta with DMARDS Option B: Methotrexate is given, as it comes under DMARDS. Option C: Anti-Histone antibodies used in drug induced SLE. Option D: We do not use steroids as routine measure in RA. 