Maxime Verhoeven

123 Effectiveness and safety of treat-to-target strategies over 5 years The mean dosage of MTX was higher in the MTX initiation strategy group during the trial period compared with the TCZ initiation strategy groups. During the post-trial follow-up, the mean dosage of MTX increased in the TCZ initiation strategy groups, but it remained higher in the MTX initiation strategy group, Supplementary Figure S3. Regarding to TCZ use, the mean dosage TCZ is more or less equal in the initial treatment strategy groups after 1 and 2 years. However, during the post-trial follow-up, TCZ use increased in the TCZ initiation strategy groups and decreased in the MTX initiation strategy group, Supplementary Figure S4. During U-Act-Early, starting after 6 months, TCZ use decreased in both TCZ strategy groups and increased in the MTX strategy group, but it remained higher in both TCZ strategy groups up till 24 months. During the post-trial follow-up, TCZ as well as total bDMARD use remained numerically higher in both TCZ strategy groups. Any other bDMARD than TCZ was used in 8% of all patients (8% TCZ+MTX, 8% TCZ and 10% MTX, respectively), Supplementary Figure S5. A reduced dose of bDMARD was mostly used in the TCZ strategy groups, where a full dose of bDMARD was mostly used in the MTX initiation strategy group. However, the total dose of bDMARD use was still higher in the TCZ initiation strategy groups, Supplementary Figure S6. Supplementary Table S4 Number of patients using RA medication during 3-year post-trial follow-up, (n=226). TCZ+MTX strategy group, n=75 TCZ strategy group, n=79 MTX strategy group, n=72 P-value Any medication for RA, n (%) 75 (100) 77 (96) 71 (99) 0.39 NSAID, n (%) 68 (91) 72 (91) 65 (90) 0.98 GCs, n (%) 41 (55) 39 (49) 48 (67) 0.09 csDMARDs, n (%) 56 (75) 58 (73) 65 (90) 0.02 - MTX, n (%) 38 (51) 48 (61) 51 (71) bDMARDs, n (%) 40 (53) 36 (46) 26 (36) 0.11 - TCZ, n (%) 38 (51) 30 (38) 21 (29) TCZ+MTX= tocilizumab + methotrexate initiation strategy group; TCZ= tocilizumab + placebo- methotrexate initiation strategy group; MTX= methotrexate + placebo-tocilizumab initiation strategy group; RA= rheumatoid arthritis; NSAID= non-steroidal anti-inflammatory drugs; GCs= glucocorticoids; csDMARDs= conventional synthetic disease modifying anti-rheumatic drugs; MTX= methotrexate; bDMARDs= biological disease modifying anti-rheumatic drugs; TCZ= tocilizumab. 6