Trial reportAnnals of the rheumatic diseases2014
Randomised comparison of initial triple DMARD therapy with methotrexate monotherapy in combination with low-dose glucocorticoid bridging therapy; 1-year data of the tREACH trial.
Trial report in Annals of the rheumatic diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 4 syntheses or guidelines pooled it, 125 citations in OpenAlex.
- Efficacy of methotrexate in reducing the risk of bone erosion in patients with rheumatoid arthritis: a systematic review of randomized controlled trials.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021Pooled it
- Effectiveness of Remission Induction Strategies for Early Rheumatoid Arthritis: a Systematic Literature Review.Current rheumatology reports · 2019Pooled it
- [S2e guideline: treatment of rheumatoid arthritis with disease-modifying drugs].Zeitschrift fur Rheumatologie · 2018Guideline
- Efficacy of conventional synthetic disease-modifying antirheumatic drugs, glucocorticoids and tofacitinib: a systematic literature review informing the 2013 update of the EULAR recommendations for management of rheumatoid arthritis.Annals of the rheumatic diseases · 2014Pooled it
- Trial
- Effect of an Online, Interactive Lifestyle Intervention Program on 12-Month Disease Management Outcomes: Protocol for The Healthy Living in Inflammatory Arthritis (HELIA) Randomized Controlled Trial.JMIR research protocols · 2026Trial
- Responsiveness and sensitivity of PROMs to change in disease activity status in early and established rheumatoid arthritis.Rheumatology (Oxford, England) · 2025Trial
- Trial
- Comparing cost-utility of DMARDs in autoantibody-negative rheumatoid arthritis patients.Rheumatology (Oxford, England) · 2021Trial
- Active conventional treatment and three different biological treatments in early rheumatoid arthritis: phase IV investigator initiated, randomised, observer blinded clinical trial.BMJ (Clinical research ed.) · 2020Trial
- Two-year cost effectiveness between two gradual tapering strategies in rheumatoid arthritis: cost-utility analysis of the TARA trial.Annals of the rheumatic diseases · 2020Trial
- Leflunomide monotherapy versus combination therapy with conventional synthetic disease-modifying antirheumatic drugs for rheumatoid arthritis: a retrospective study.Scientific reports · 2020Trial
- Baseline pain severity is associated with short-term pain reduction after intramuscular glucocorticoids; other clinical characteristics are not associated: a prospective cohort study.Clinical rheumatology · 2026Article
- Optimising Conventional Therapy in Rheumatoid Arthritis.Mediterranean journal of rheumatology · 2026Review
- Article
- Article
- The prognostic value of IgA anti-citrullinated protein antibodies and rheumatoid factor in an early arthritis population with a treat-to-target approach.Immunologic research · 2024Article
- Review
- Machine learning identifies a profile of inadequate responder to methotrexate in rheumatoid arthritis.Rheumatology (Oxford, England) · 2023Article
- The impact of different (rheumatoid) arthritis phenotypes on patients' lives.Rheumatology (Oxford, England) · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo compare 1-year clinical efficacy of (1) initial triple disease-modifying antirheumatic drug therapy (iTDT) with initial methotrexate (MTX) monotherapy (iMM) and (2) different glucocorticoid (GC) bridging therapies: oral versus a single intramuscular injection in early rheumatoid arthritis.
methodsIn a single-blinded randomised clinical trial patients were randomised into three arms: (A) iTDT (methotrexate+sulfasalazine+hydroxychloroquine) with GCs intramuscularly; (B) iTDT with an oral GC tapering scheme and (C) MTX with oral GCs similar to B. Primary outcomes were (1) area under the curve (AUC) of Health Assessment Questionnaire (HAQ) and Disease Activity Score (DAS) and (2) the proportion of patients with radiographic progression.
results281 patients were randomly assigned to arms A (n=91), B (n=93) or C (n=97). The AUC DAS and HAQ were respectively -2.39 (95% CI -4.77 to -0.00) and -1.67 (95% CI -3.35 to 0.02) lower in patients receiving iTDT than in those receiving iMM. After 3 months, treatment failure occurred less often in the iTDT group, resulting in 40% fewer treatment intensifications. The difference in treatment intensifications between the arms required to maintain the predefined treatment goal remained over time. No differences were seen between the two GC bridging therapies. Respectively 21%, 24% and 23% of patients in arms A, B and C had radiographic progression after 1 year. Patients receiving iTDT had more adjustments of their medication owing to adverse events than those receiving iMM.
conclusionsTreatment goals are attained more quickly and maintained with fewer treatment intensifications with iTDT than with iMM. However, no difference in radiographic progression is seen. Both GC bridging therapies are equally effective and, therefore, both can be used. TRIAL REGISTRATION NUMBER: ISRCTN26791028.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.