“…The updated systematic review by Nam et al (2014) used to inform the 2013 update of the European League against Rheumatism (EULAR) guidelines for the management of RA concluded that although there was some additional evidence for the use of biologic monotherapy, a biologic in combination with MTX is more efficacious than the same biologic agent alone. In addition, there is also accumulating evidence from trial and registry data that the coprescription of MTX with biologics improves drug survival and persistence with the therapy (Blum et al, 2011;Soliman et al, 2011;Iannone et al, 2012), so combination therapy is now recommended in most treatment guidelines for the use of TNF inhibitors in RA.…”