MRCP2-4767
A 65-year-old patient with a long history of rheumatoid arthritis presents for follow-up. She is currently being treated with low-dose methotrexate, folic acid, and non-steroidal anti-inflammatory drugs for her condition. However, she has noticed a deterioration in her rheumatoid nodules over the past few months and has recently developed dry eyes. During the examination, splenomegaly is noted. Further investigations reveal a low total white count of 3.4 × 109/l, along with anemia and a platelet count of 105 × 109/l. What would be the most appropriate initial intervention in this case?