A 48-year-old female with pain and swelling in almost all joints of the body. She underwent thyroid lobectomy before 6 years for mng . She also has irregular periods for s past 1 year. Her blood analysis shows elevated ESR, negativity for ana Anti-ccp.

She has insomnia for which she takes pregabalin 75mg. She also had a course of alpha D3 supplementation. Other illness she has is allergic rhinitis and also recently checked HbA1C s 7. Kindly suggest the management.