A patient on methotrexate and adalimumab for RA returns for follow-up. He reports that his joint pain is well-controlled, but he has a fever, productive cough, and feels very fatigued. What is the most appropriate next step?

Question

Answer

Hold the adalimumab and evaluate for a serious infection.

Answer

Reassure the patient that these are common side effects of TNF-inhibitors.

Answer

Order a CBC to check for methotrexate-induced myelosuppression.

Answer

Administer influenza vaccine.

Answer

Prescribe a course of oral antibiotics.

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A patient on methotrexate and adalimumab for RA returns for follow-up. He report...

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