Important questions to be answered in future combination studies
| • Can remission rates be improved if combination therapy is started during the “very early” phase? |
| • Should combination therapy be used first in all patients or only in a proportion of patients not responding to DMARD monotherapy? |
| • If combination therapy is used first, what is the optimal maintenance regimen? |
| • Is it best to use anti-TNF in all patients or only in patients with suboptimal response to methotrexate? |
| • Should corticosteroids be used in all patients? If so, should it be used in a high dose or low dose? |
| • What is the role of leflunomide in early RA? |
| • Would different strategies work best with one combination of drugs rather than another? |
| • Which subsets of patients would benefit the most from combination therapy? Should the most aggressive treatment be offered to patients who are likely to have a worse long term outcome? |