A 45-year-old man presents with a 6-month history of symmetric joint pain and swelling primarily affecting his hands and feet, associated with morning stiffness lasting over an hour. Physical exam reveals swollen and tender metacarpophalangeal and proximal interphalangeal joints. Lab tests show elevated ESR and positive anti-CCP antibodies. Which of the following is the most appropriate initial disease-modifying antirheumatic drug (DMARD)?
✓ Correct Answer: Option C
This presentation is consistent with rheumatoid arthritis. Methotrexate is considered the first-line conventional synthetic DMARD for most patients, initiated early to prevent joint damage and disease progression. Prednisone and Ibuprofen are for symptom control, not disease modification.