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The following patient on Methotrexate, steroids and NSAIDs for past 4 months has had no retardation of disease progression. What is the next rational step in management?

A
Sta monotherapy with anti-TNF alpha drugs
B
Continue Methotrexate and steroids at higher dose
C
Stop oral Methotrexate and sta parenteral Methotrexate
D
Add Sulfasalazine
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