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Drug Therapy for Rheumatoid Arthritis in Adults

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Summary of Results: DMARD Combinations Versus Monotherapies

In patients with longstanding active rheumatoid arthritis with inadequate disease control, head-to-head comparisons were made of combined DMARDs and DMARD monotherapy. Overall, combination treatment with biologic DMARDs and an oral DMARD is more effective than either used as monotherapy. Disease activity, radiographic progression, functional status, and quality of life all are greater improved with the combination therapy. The strength of evidence for these findings varies among the specific outcomes, with most supported by moderate or high strength of evidence.

DMARD = disease-modifying anti-rheumatic drug; MTX = methotrexate; RA = rheumatoid arthritis; RCT = randomized controlled trial; SOE = strength of evidence; SSZ = sulfasalazine