Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative.

79 80 In DMARD-naive patients, combination therapy showed a trend for more EULAR moderate response and remission, but only ACR70 responses were significantly more often achieved (RR 2.41; 95% CI 1.07 to 5.44). 81 – 85 Regarding toxicity, methotrexate combined with sulfasalazine and methotrexate combined with leflunomide each significantly increased the risk of ga

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