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What do systematic reviews say?

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Evidence found and GRADE certainty

207 questions · 223 findings · 29 reviews · Headline outcomes only

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No studies found 43 · 19.3%GRADE not reported 14 · 6.3%Very low 39 · 17.5%Low 67 · 30%Moderate 54 · 24.2%High 6 · 2.7%

MTX combination vs MTX monotherapy

ACR 50 response of DMARDs naive patients Number of responders · patients with rheumatoid arthritis

MTX combination showed no clear difference in ACR 50 response of DMARDs naive patients Number of responders compared with MTX monotherapy (low certainty).

1 finding from 1 review

MTX combination vs MTX monotherapy

ACR 50 response of MTX inadequate responders number of responders · patients with rheumatoid arthritis

MTX combination probably leads to higher ACR 50 response of MTX inadequate responders number of responders compared with MTX monotherapy (moderate certainty).

1 finding from 1 review

MTX combination vs MTX monotherapy

ACR 50 response of non‐MTX DMARDs inadequate responders number of responders · patients with rheumatoid arthritis

MTX combination showed no clear difference in ACR 50 response of non‐MTX DMARDs inadequate responders number of… compared with MTX monotherapy (moderate certainty).

1 finding from 1 review

MTX combination vs MTX monotherapy

Withdrawal due to lack of efficacy or toxicity of DMARDs naive patients number of withdrawals · patients with rheumatoid arthritis

MTX combination showed no clear difference in withdrawal due to lack of efficacy or toxicity of DMARDs naive… compared with MTX monotherapy (moderate certainty).

1 finding from 1 review

MTX combination vs MTX monotherapy

Withdrawal due to lack of efficacy or toxicity of MTX inadequate responders number of withdrawals · patients with rheumatoid arthritis

MTX combination showed no clear difference in withdrawal due to lack of efficacy or toxicity of MTX inadequate… compared with MTX monotherapy (moderate certainty).

1 finding from 1 review

MTX combination vs MTX monotherapy

Withdrawal due to lack of efficacy or toxicity of non‐MTX DMARDs inadequate responders number of withdrawals · patients with rheumatoid arthritis

It is very uncertain whether MTX combination changes withdrawal due to lack of efficacy or toxicity of non‐MTX DMARDs… compared with MTX monotherapy (very low certainty).

1 finding from 1 review

MTX combination vs MTX monotherapy

Withdrawals due to adverse events · patients with rheumatoid arthritis

It is very uncertain whether MTX combination changes withdrawal due to adverse reactions (Pooled across regimens) number… compared with MTX monotherapy (very low certainty).

1 finding from 1 review