Patients were randomized to @ treatment arms : triple disease-modifying antirheumatic drug ( DMARD ) therapy ( consisting of MTX , sulfasalazine , and hydroxychloroquine -LSB- HCQ -RSB- ) + intramuscular ( IM ) glucocorticoids , triple DMARD therapy + oral glucocorticoids , MTX + oral glucocorticoid therapy , MTX therapy , oral glucocorticoid therapy , and HCQ therapy .