Teitsma XM, et al. - Experts evaluated and validated clinical baseline predictors related to inadequate response (IR) to methotrexate (MTX) therapy in newly diagnosed patients with rheumatoid arthritis (RA). In U-Act-Early, they randomised disease-modifying antirheumatic drug (DMARD)-naive patients with RA to initiate MTX therapy and treated to target until sustained remission (disease activity score assessing 28 joints (DAS28) <2.6 with 4 or less swollen joints for ≥24 weeks) was achieved. For IR to step-up ‘MTX+’ in DMARD-naive patients with new-onset RA, higher DAS28, current smoking and no alcohol consumption were predictive factors. The AUROC slightly decreased to 0.67 and the PPV and NPV to 54% and 80%, respectively, while applying the model to the validation cohort.