Kang EH, et al. - Through a cohort study, researchers contrasted the risk of serious infections between the TNF inhibitor (TNFi) plus methotrexate (MTX) with triple therapy among RA patients in a real-world setting. A total of 45,208 and 1,387 TNFi plus MTX initiators and triple therapy initiators were involved, following propensity score (PS) stratification (PSS) and weighting. The mean age was 53 years and 70% were women. In TNFi plus MTX and in triple therapy, the incidence rate of any serious infection per 100 person-years was 2.46 and 2.03, respectively. For any serious infection, the PSS-weighted HR contrasting TNFi plus MTX vs triple therapy was 1.23. For the secondary outcomes, the PSS-weighted HR for bacterial infection and for herpes zoster was 1.41 and 0.80, respectively. Therefore, no substantially different risk of any serious infection, bacterial infection or herpes zoster following beginning TNFi plus MTX vs triple therapy was concluded, however, confidence intervals were wide.