title: [Biologics as first line therapy in the treatment of rheumatoid arthritis. An opposing point of view].
abstract: The development of biologic therapies has improved the prognosis of rheumatoid arthritis (RA). However, at present there is not enough evidence supporting that TNF antagonists, anti CD20 therapy or abatacept used as first line therapy provide relevant long-term benefits in daily clinical practice. Furthermore, clinical trials that analyze the effect of the combination of methotrexate (MTX) plus TNF antagonists against MTX monotherapy have shown that the later provides significant clinical responses and relevant radiological damage arrest in patients with early RA. Therefore, considering that in 5-6 months we can detect which patients do not respond adequately to MTX, we can select those patients for biologic therapy avoiding the exposure to the putative adverse events of combination therapy to those patients with optimal response to MTX monotherapy.
authors.affiliation: Servicio de Reumatología, Hospital Universitario de la Princesa, Madrid, España.
authors.forename: Isidoro
authors.initials: I
authors.lastname: González Álvaro