Maxime Verhoeven

23 Systematic review of remission-induction strategies in early RA A quality assessment of all selected publications was performed using “The Cochrane Collaboration’s tool for assessing risk of bias”. 9 Information about random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome assessment and selective reporting was evaluated. Statistics Relative risks (RR) for achieving remission with 95% confidence intervals (CI) per study were calculated, separate for each remission outcome definition and graphically displayed in forest plots. When appropriate, results were pooled using a random-effect model according to the Mantel-Haenszel method. To explore the effects of specific remission-induction strategy used (e.g., use of a b/tsDMARD, the use of GC bridging therapy in the single csDMARD-initiating strategy) and the effect of symptom duration at start of therapy (within the window of opportunity, arbitrarily defined as symptom duration ≤3 months, versus outside the window of opportunity, arbitrarily defined as symptom duration >3 months), 2 group analyses were performed. Outcomes of studies evaluating the longer term effectiveness of remission-induction strategies were only summarized descriptively. All analyses were performed in Review manager version 5.3. 10 RESULTS After screening, 23 articles and 6 conference abstracts were included, involving 6319 patients treated according to a remission-induction strategy and 4647 according to a single csDMARD-initiating strategy (see flowcharts in Supplementary Figure S1). Four specific groups were defined based on characteristics of the drug regime and study duration, and comparisons made; 1) b/tsDMARD based remission-induction strategy versus single csDMARD-initiating strategy without GC bridging, 2) combination csDMARD based remission-induction strategy versus single csDMARD-initiating strategy without GC bridging, 3) remission-induction strategy (either combination csDMARD based strategy or bDMARD based strategy) versus single csDMARD-initiating strategy with GC bridging, and 4) studies evaluating long-term effects of remission-induction strategies (follow-up >4 years). An overview of patient and study characteristics of the included studies is shown in Table 1. 2