Arm 1 | Dosage form | Dosage regimen | Duration |
---|---|---|---|
ETN | Subcutaneous | 50mg weekly | Up to week 48 unless non-response or intolerance. |
MTX | 2.5/10mg tablets (or s.c. if oral not tolerated) | Weeks 0-4: 15 mg weekly Week 4: 20 mg weekly Week 8 onwards: 25 mg weekly | For duration of study (unless intolerance: aim for maximum tolerated dose) |
Folic Acid | 5mg tablets | 5mg, six days per week (not day of MTX) | For duration of study (if receiving MTX) |
Arm 2 | Â | Â | Â |
MTX | 2.5/10mg tablets (or s.c. if oral not tolerated) | Weeks 0-2: 15 mg weekly Week 2 onwards: 25 mg weekly | For duration of study (unless intolerance, aim for maximum tolerated dose) |
Folic Acid | 5mg tablets | 5mg six days per week (not day of MTX) | For duration of study (if receiving MTX) |
SSZ | 500 mg tablets | 1 g twice a day | At/after week 8 if not achieving low disease activity (DAS28ESR > 3.2). Discontinuation if ETN is started at week 24. |
HCQ | 200mg tablets | 200mg tablets | At/after week 8 if not achieving low disease activity (DAS28ESR > 3.2). Discontinuation if ETN is started at week 24. |
ETN | Subcutaneous | 50mg weekly | At week 24 to week 48 if not achieving remission (DAS28ESR ≥ 2.6) Thereafter continuation will be determined by physician judgement/according to national guidelines. |