Patients were randomized to 6 treatment arms : triple disease-modifying antirheumatic drug ( DMARD ) therapy ( consisting of MTX , sulfasalazine , and hydroxychloroquine [ HCQ ] ) + intramuscular ( IM ) glucocorticoids , triple DMARD therapy + oral glucocorticoids , MTX + oral glucocorticoid therapy , MTX therapy , oral glucocorticoid therapy , and HCQ therapy .