The first-line tumor necrosis factor inhibitors (TNFis) show notable improvements over one year among individuals with MTX-naïve RA, as per the findings of a Systematic Literature Review and Meta-Analysis published in the Journal of Advances in Therapy.

Previous Cochrane Central Register of Controlled Trials, PubMed, and systematic reviews were examined for randomized controlled trials (RCTs) which contain data regarding management of methotrexate-naïve RA persons using the first-line TNFis. Literature was incorporated qualitatively, and a meta-analysis directed to assess clinical remission, Health Assessment Questionnaire Disability Index (HAQ), and American College of Rheumatology (ACR) responses at Years 2 and/or 5.

A total of 10 RCTs comprising 4306 patients were selected. Seven studies were entirely or partly open-label, and the other three studies were double-blind (for two years). Five studies (all were open-label) described data at Year 5. Further, Not open-label but double-blind RCTs showed considerably improved ACR70 response, ACR50 response, and remission rates with first-line TNFi treatment at Year 2. The between-group differences in mean HAQ at Year 2 were also negligible in open-label or double-blind RCTs or ACR response or remission outcomes at Year 5.

This was the first type of analysis that gives evidence regarding TNFs efficacy over one year in MTX-naive early RA patients. However, more investigation is required to assess the efficiency of TNFi therapy over ≥ 2 years among individuals with methotrexate-naïve RA.