Table 1A

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 actionbDMARD or tsDMARDYear of publicationRA disease duration according to the inclusion criteria% of patients achieving remission in the combination arm% of patients achieving remission in the methotrexate monotherapy armTime-pointCorticosteroid use
TNF inhibitionInfliximab
20143–12 months40.650.8Week 26Single intravenous methylprednisolone in MTX arm only
TNF inhibitionAdalimumab (OPERA)212014<6 months74491 yearIntra-articular corticosteroids
Costimulation inhibitorAbatacept (AVERT)242015~0.6 years
(symptom duration <2 years)
60.945.26 months<10 mg/day
TNF inhibitionCertolizumab pegol (C-EARLY)222017<1 year29151 year~30% of patients,<10 mg/day
IL6-R blockadeTocilizumab (U-Act-Early)152016<1 year86442 yearsNot permitted
  • bDMARDs, biologic DMARDs; DMARDs, disease-modifying antirheumatic drugs; IL6-R, interleukin 6 receptor; MTX, methotrexate; RA, rheumatoid arthritis; TNF, tumor necrosis factor; tsDMARDs, targeted synthetic DMARDs.