What is the initial treatment of choice for suppressing the progression of rheumatoid arthritis (RA)?

The initial treatment of choice for suppressing the progression of rheumatoid arthritis (RA) is methotrexate. Methotrexate is a Disease-Modifying Anti-Rheumatic Drug (DMARD) that is widely used due to its ability to not only alleviate symptoms but also slow down the disease course and prevent joint damage. It acts by inhibiting the proliferation of cells that contribute to the inflammatory process in RA, thus modifying the disease rather than just addressing the pain and inflammation.

This medication is often preferred as it has a robust evidence base supporting its efficacy in improving long-term outcomes for patients with RA. Compared to other treatments, methotrexate has shown a significant capacity to reduce the progression of disease, leading to fewer joint deformities and better preservation of function over time.

Other options, while they may be useful in certain contexts, do not provide the same level of disease modification. Naproxen sodium primarily helps with symptomatic relief through its anti-inflammatory properties but does not alter the disease’s progression. Prednisone can also provide rapid relief of inflammation and pain, but its long-term use is limited due to potential side effects and it is not a DMARD. Gold salts were historically used for RA but have largely fallen out of favor due to their