““Managing patients first with triple therapy and switching to a biologic plus methotrexate in those who do not have an adequate response may be more cost-effective, without adversely affecting clinical outcomes. A recent study did not find a difference between biologics and triple therapy in time to return to work ( 2 ). Cost-effectiveness trials and long-term follow-up studies are needed to assess the durability of intermediate outcomes (such as disease activity) with patient-centered outcomes.””
