Dear All,

Deepawali Greetings!

Highlight of this issue is “Targeted treatment with a combination of traditional DMARDs produces excellent clinical and radiographic long-term outcomes in early rheumatoid arthritis regardless of initial infliximab. The 5-year follow-up results of a randomized clinical trial, the NEO-RACo trial.” The study results clearly show that in early RA, targeted treatment with a combination of traditional DMARDs and prednisolone induces remission and minimizes radiographic progression in most of the patients up to 5 years; adding initial infliximab for 6 months does not improve these outcomes. Meta-analysis in practice matters “Effect of Combination Therapy on Joint Destruction in Rheumatoid Arthritis: A Network Meta-Analysis of Randomized Controlled Trials” also shows that combination treatment of a biologic agent with one DMARD is not superior to 2–3 DMARDs including or excluding low- dose corticosteroids in preventing structural joint damage. Results from NEO-RACo trial and the meta-analysis show that most RA patients can achieve and sustain remission without using costly biologic agents. Another message is superiority of combination therapy on monotherapy that is clear in this meta-analysis.

Regards,

Banwari Sharma
Editor, IRA e-News Letter