Maxime Verhoeven

112 Chapter 6 Figure 2 DAS28 over 5 years as predicted by model. UAE= U-Act-Early; TCZ+MTX= tocilizumab + methotrexate initiation strategy group; TCZ= tocilizumab + placebo-methotrexate initiation strategy group; MTX= methotrexate + placebo-tocilizumab initiation strategy group; follow-up= post-trial follow-up. Medication use during the 3-year post-trial follow-up Any medication for RA was used by 75 patients (100%) in the TCZ+MTX initiation strategy group, 77 (96%) in the TCZ initiation strategy group and 71 (99%) in the MTX initiation strategy group, respectively (p=0.39). NSAIDs were used by 68 (91%) patients in the TCZ+MTX initiation strategy group, 72 (91%) in the TCZ initiation strategy group and 65 (90%) in the MTX initiation strategy group, respectively (p=0.98). The number of patients using GCs was numerically higher (although not statistically significantly) in the MTX initiation strategy group (n=47, 67%) compared with the TCZ+MTX (n=41, 55%) and TCZ (n=39, 49%) initiation strategy groups (p=0.09). csDMARDs were used by more patients in the MTX initiation strategy group (n=65, 90%) compared with the TCZ+MTX (n=56, 75%) and TCZ (n=58, 73%) initiation strategy groups (p=0.02). In contrast, the number of patients using bDMARDs was numerically higher in the TCZ+MTX (n=40, 53%) and TCZ (n=36, 46%) initiation strategy groups than in the MTX initiation strategy group (n=26, 36%), although not statistically significantly (p=0.11). Any other bDMARD than TCZ was used by 8% of all patients (8% TCZ+MTX, 8% TCZ and 10% MTX, respectively). Additional information about medication use is provided in Supplementary Table S4 and Figures S2-6. Sustained (drug free) remission Over 5 years, SR was achieved at least once by 224 of the 226 patients (99%) and the proportions of patients achieving SR were not statistically significantly different (p=0.15; Table 2) between the initial strategy groups. The cumulative duration of SR was