Erhardt DP, et al. - Given that combination therapies for patients with rheumatoid arthritis (RA) with an insufficient response to methotrexate (MTX) alone included the addition of a tumor necrosis factor inhibitor (TNFi) or the addition of sulfasalazine (SSZ) and hydroxychloroquine to MTX (triple therapy), researchers contrasted persistence [defined as treatment without a ≥ 90-day gap in therapy] and adherence [calculated using the proportion of days covered ≥ 80% at 12 months] rates between these two combination therapies in US veterans and report the reasons for discontinuation of combination treatment in these groups. Veterans with RA escalating treatment from MTX to MTX-TNFi or triple therapy were analyzed for a 12-month period after combination initiation utilizing Veteran's Affairs clinical and administrative data from 2006 to 2012. Chart abstraction identified the reasons that patients discontinued their combination regimens. Data reported that full persistence at 1 year was 45% in the MTX-TNFi patients (n = 2,125) and 18% in the triple therapy patients (n = 171). Findings suggested that differences in persistence and adherence between the groups of MTX-TNFi and triple therapy seem to be primarily associated with adverse drug events most frequently attributed to SSZ.