Randomised clinical trials of bDMARDs and tsDMARDs in combination with methotrexate compared with methotrexate alone in methotrexate-naïve patients with RA with disease duration >1 year
| Mechanism of action | bDMARD or tsDMARD | Year of publication | RA disease duration | % of patients achieving remission in the combination arm | % of patients achieving remission in the methotrexate monotherapy arm | Time-point | Corticosteroid use |
| TNF inhibition | Infliximab (ASPIRE)20 | 2004 | <3 years | 21.20 | 15.00 | Week 54 | ~38% of patients, ≤10 mg/day prednisone |
| TNF inhibition | Adalimumab (PREMIER)16 | 2005 | <3 years | 43.00 | 21.00 | 1 year | ~33% of patients, mean dose prednisolone 6.5 mg/day |
| TNF inhibition | Etanercept (COMET)17 | 2008 | <2 years | 50.00 | 28.00 | Week 52 | ~50%, <1 mg/day |
| TNF inhibition | Golimumab (GO-BEFORE)23 | 2009 | ~3 years | 38.00 | 28.00 | Week 24 | ~67% of patients (<10 mg/day) |
| IL6-R blockade | Tocilizumab (FUNCTION)25 | 2015 | <2 years | 45.00 | 15.00 | Week 24 | ~40% of patients |
| B-cell depletion | Rituximab (IMAGE)19 | 2010 | ≤4 years | 31.00 | 13.00 | Week 52 | ≤10 mg/day |
| JAK/STAT inhibition | Tofacitinib (ORAL Start)26 | 2014 | ~3 years | 14.60 | 7.60 | 6 months | NA |
| JAK/STAT inhibition | Baricitinib (RA begin)27 | 2017 | ~1.5 years | 40.00 | 24.00 | Week 24 | 36% of patients |
| Costimulation inhibitor | Abatacept (AGREE)18 | 2009 | <2 years | 41.10 | 23.30 | 12 months | ~35% of patients, mean dose 7 mg/day |
bDMARDs, biologic DMARDs; DMARDs, disease-modifying antirheumatic drugs; JAK/STAT, Janus Kinase/ Signal Transducer and Activator of Transcription proteins; NA, not available; TNF, tumor necrosis factor; tsDMARDs, targeted synthetic DMARDs.