Kavanaugh A, et al. - The goal of this investigation was to compare responses in patients with early rheumatoid arthritis (RA) initially treated with the tumour necrosis factor inhibitor (TNFi) adalimumab+methotrexate (MTX) vs MTX monotherapy who may have continued receiving MTX or switched to adalimumab rescue therapy after inadequate response to MTX. Among patients with early RA, those who started MTX monotherapy with add-on TNFi after 26 weeks had longer-term clinical outcomes that were similar to those who started with TNFi+MTX combination therapy but the former treatment strategy permitted a small but significant accrual of radiographic damage.