The combination of DMARDs (MTX, SSZ with prednisone21 or MTX, SSZ, hydroxychloroquine [HCQ] with prednisone) 22 has been shown to be more effective than monotherapy, and have achieved higher remission rates, less radiological progression and less work absenteeism. Likewise, the use of anti-TNF, mainly combined with MTX, generates a higher rate of clinical remission and lower radiological progression compared with monotherapy with DMARD.
Inhibitors of TNF alpha have shown high efficacy in the control of signs and symptoms in established RA, as well as in the reduction of the progression of joint damage Flekosteel, improvement in quality of life and preservation of functional status.
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