As per the findings of the Bayesian present mixed treatment comparisons (MTCs) published in 'Clinical Rheumatology', Tofacitinib, Etanercept and Rituximab are the highest probability drugs of inducing an ACR50 or ACR70 responses at 12 months in the early stage of the disease (ERA) patients with disease duration <1 year.

The present paradigm in rheumatoid arthritis (RA) management is to treat patients in the ERA. Earlier meta-analysis-based MTCs, focused on identifying the most effective drugs in ERA, which are biased by the broad "window" of early definition, varying from 6 months to 2 years. In this study, Vincenzo Venerito et al. aimed to evaluate through a Bayesian Network Meta-Analysis that which biologics or small molecules are more likely to attain a 1-year good clinical response in ERA patients with disease duration < 1 year.
Randomized controlled trials (RCTs) of biologic agents and small molecules in combination with MTX to treat patients affected with ERA lasting < 1 year were searched using EMBASE, MEDLINE, Cochrane Library, and Clinicaltrials.gov between the year 1990 and September 2017 as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. At 1 year, the outcome of interest was the achievement of the American College of Rheumatology (ACR) 50 and ACR 70 response. Using a fixed-effect model, WinBUGS 1.4 software was used for assessment. Total of 14 studies was considered in this analysis. Tofacitinib (64.83%) and then, Etanercept (23.26%) had the highest probability of achieving the ACR50 response. Rituximab depicted the highest likelihood of inducing ACR70 response (52.81%) and followed by Etanercept (26.85%).

The study authors concluded, "Further RCTs, possibly considering head-to-head comparisons and involving radiological along with clinical outcomes, on RA patients with accurate time definition of early disease are awaited."