A 27-year-old woman comes to the physician for a 3-month history of worsening pain in her hands, wrists, and knees. Her father has type I diabetes mellitus. In addition to ibuprofen and prednisone, the most appropriate pharmacotherapy has which of the following mechanisms of action?
A) Inhibition of CD20
B) Inhibition of dihydrofolate reductase
C) Inhibition of dihydropteroate synthase
D) Monoclonal antibody against soluble TNF-alpha
E) Monoclonal antibody against TNF-alpha receptor
F) Recombinant receptor against soluble TNF-alpha
