FRI0190 Induction-Maintenance in Early RA: A Meta-Analysis of Trials Using MTX plus TNF-Inhibitor as Induction Therapy

BackgroundThe goal of rheumatoid arthritis (RA) treatment is remission or, when not achievable, low-disease-activity (LDA). Initial combined therapy with MTX + TNF-inhibitor (TNFi) achieves these goals more often than MTX alone, but at a high cost. Some trials have therefore used the combined treatment for a limited time only (“induction-maintenance”).ObjectivesIt has remained unclear if the benefits from the induction phase are sustained during maintenance, and individual trials may not have been sufficiently powered to resolve this issue. Therefore, we performed a meta-analysis of trials using the initial combination of MTX+ TNFi in DMARD-naïve early RA-patients.MethodsA systematic literature search was performed for induction-maintenance randomized controlled trials where initial combination therapy was compared with MTX-monotherapy in patients with clinically active early RA. Our primary outcome was the proportion of patients who achieved LDA (DAS28