Maxime Verhoeven

29 Systematic review of remission-induction strategies in early RA Figure 2 Forest plot of Boolean remission outcome in individual studies comparing remission-induction strategies with single csDMARD-initiating strategies. Boolean remission= tender joint count ≤1, swollen joint count ≤1, CRP ≤1 mg/dL, patient global assessment ≤1 (on a 0-10 scale); Induction= remission-induction strategy arm; csDMARD= single csDMARD-initiating strategy arm; M-H= Mantel-Haenszel; Random= random effect; CI= confidence interval; *= bDMARD based remission-induction strategy. CDAI-based remission Only studies with b/tsDMARD use in the remission-induction strategy versus single csDMARD-initiating strategy without GC bridging were included in the analysis for CDAI remission. All studies (7/7, 100%) showed a statistical significant effect in favor of the remission-induction strategy arm. The pooled RR of achieving CDAI remission was 1.68 [95%CI 1.46 - 1.92], Figure 3. SDAI-based remission Nine studies with bDMARD use in the remission-induction strategy arm versus single csDMARD-initiating strategy without GC bridging, and one study using a bDMARD based remission-induction strategy versus a single csDMARD-initiating strategy with GC bridging were included in the analysis for SDAI remission. 29 A significant effect in favor of the remission-induction strategy was found in 7/10 (70%) studies, Figure 4. The pooled RR of achieving SDAI remission was 1.66 [95%CI 1.44 - 1.90] for bDMARD use in the remission- induction strategy arm versus the single csDMARD-initiating strategy without GC bridging arm. And for the single study where a remission-induction strategy was compared to a single csDMARD-initiating strategy with GC bridging, this was 1.10 [95%CI 0.60 - 2.05]. 2