Therapeutic effect of the combination of etanercept and methotrexate compared with each treatment alone in patients with rheumatoid arthritis: double-blind randomised controlled trial

TNFα blockade in human diseases: An overview of efficacy and safety

“…Addition of an anti-TNF agent to MTX significantly improved patient outcomes [6][7][8][9][10]. Subsequent clinical trials evaluated whether the combination of a DMARD and an anti-TNFα agent was superior to either agent alone [11,12] or compared an anti-TNF agent with placebo [13,14]. Emboldened by the positive results of these trials, investigators probed a window of opportunity by asking whether treating patients with an anti-TNF agent in early stages (less than 3 years) of disease could 'wipe out' the disease and provide long-lasting remissions [12,[15][16][17].…”

Superior efficacy of combination therapy for rheumatoid arthritis: Fact or fiction?

“…The mechanism(s) by which MTX reduces the human antichimeric or anti-human antibody response remains to be more completely elucidated. However, the TEMPO (Trial of Etanercept and Methotrexate with Radiographic Patient Outcomes) study (see below), in which even the combination of etanercept with MTX was superior to etanercept alone, suggests that MTX may have other (or additional) effects beyond its effects on immunogenicity (50 (50,52). Similar evidence has been provided by the ASPIRE (Active-Controlled Study of Patients Receiving Infliximab for the Treatment of Rheumatoid Arthritis of Early Onset) trial using infliximab (53).…”

Targeting Interleukin-6 in Rheumatoid Arthritis

“…More importantly, there is a lack head-to-head success in regards to superiority of the biologics given as monotherapy against methotrexate [3][4][5]. Even when a TNF-inhibitor is given in combination with DMARDs, the rate of inadequate response has been quoted about 20-40% in various populations studied [6], prompting the clinician to switch to different form of biologics.…”