What is considered the sole disease-modifying therapy for rheumatoid arthritis?

• A. Methotrexate
• B. Hydroxychloroquine
• C. Sulfasalazine
• D. TNF inhibitors

Answer: (A)

In rheumatoid arthritis, slowing joint damage with a disease-modifying therapy is the central goal. Methotrexate has the strongest evidence as a single agent for reducing radiographic progression and improving long-term function, making it the foundational first-line therapy. Other conventional DMARDs like hydroxychloroquine or sulfasalazine can help control disease but generally have a slower onset and a weaker impact on structural damage when used alone, and are often used in combination. TNF inhibitors are effective disease-modifying medications, but they’re typically used after methotrexate or in combination with it, not as the sole stand-alone option. So methotrexate is the best answer because it is the most established single-agent DMARD with proven ability to slow structural damage in RA.