somewordstoolate/Q2CRBench-3 huggingface dataset:
Guideline: 2021 ACR RA
Clinical question: Should patients with MTX-naïve and non-MTX csDMARDs exposed RA and moderate to high disease activity receive MTX monotherapy or boDMARD with MTX or tsDMARD with MTX?
Population: Patients with MTX-naïve and non-MTX csDMARDs exposed RA and moderate to high disease activity
Intervention: MTX monotherapy
Comparator: IL-6 Receptor Inhibitor + MTX
Outcome: Quality of Life (follow up: 1 year; assessed with: SF-36 PCS)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Rated down by one level for lack of allocation concealment
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: NOT_SERIOUS
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: MODERATE
No of participants: TCZ+MTX: 0 
MTX monotherapy: 0 
Effect: Relative Effect (95% CI): -
Absolute Effect (95% CI): MD 1.99 higher (0.41 higher to 3.57 higher)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with MTX-naïve and non-MTX csDMARDs exposed RA and moderate to high disease activity receive MTX monotherapy or boDMARD with MTX or tsDMARD with MTX?
Population: Patients with MTX-naïve and non-MTX csDMARDs exposed RA and moderate to high disease activity
Intervention: MTX monotherapy
Comparator: IL-6 Receptor Inhibitor + MTX
Outcome: Quality of Life (follow up: 1 year; assessed with: SF-36 MCS)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Rated down by one level for lack of allocation concealment
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: SERIOUS
rationales: Rated down by one level for imprecision as the CI includes both values suggesting no effect and values suggesting harm
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: LOW
No of participants: TCZ+MTX: 0
MTX monotherapy: 0 
Effect: Relative Effect (95% CI): -
Absolute Effect (95% CI): MD 1.25 higher (1.58 lower to 4.08 higher)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with MTX-naïve and non-MTX csDMARDs exposed RA and moderate to high disease activity receive MTX monotherapy or boDMARD with MTX or tsDMARD with MTX?
Population: Patients with MTX-naïve and non-MTX csDMARDs exposed RA and moderate to high disease activity
Intervention: MTX monotherapy
Comparator: IL-6 Receptor Inhibitor + MTX
Outcome: Withdrawal due to adverse events (follow up: 1 year)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Rated down by one level for lack of allocation concealment
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: NOT_SERIOUS
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: MODERATE
No of participants: TCZ+MTX: 94/579 (16.2%) 
MTX monotherapy: 21/282 (7.4%) 
Effect: Relative Effect (95% CI): RR 2.18 (1.39 to 3.42)
Absolute Effect (95% CI): 88 more per 1,000 (from 29 more to 180 more)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with MTX-naïve and non-MTX csDMARDs exposed RA and moderate to high disease activity receive MTX monotherapy or boDMARD with MTX or tsDMARD with MTX?
Population: Patients with MTX-naïve and non-MTX csDMARDs exposed RA and moderate to high disease activity
Intervention: MTX monotherapy
Comparator: IL-6 Receptor Inhibitor + MTX
Outcome: Serious adverse events (follow up: 1 year)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Rated down by one level for lack of allocation concealment
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: SERIOUS
rationales: Rated down by one level for imprecision as the CI includes both values suggesting no effect and values suggesting harm
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: LOW
No of participants: TCZ+MTX: 60/579 (10.4%) 
MTX monotherapy: 24/282 (8.5%) 
Effect: Relative Effect (95% CI): RR 1.22 (0.78 to 1.91)
Absolute Effect (95% CI): 19 more per 1,000 (from 19 fewer to 77 more)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with MTX-naïve and non-MTX csDMARDs exposed RA and moderate to high disease activity receive MTX monotherapy or boDMARD with MTX or tsDMARD with MTX?
Population: Patients with MTX-naïve and non-MTX csDMARDs exposed RA and moderate to high disease activity
Intervention: MTX monotherapy
Comparator: IL-6 Receptor Inhibitor + MTX
Outcome: Malignancy (follow up: 1 year)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Rated down by one level for lack of allocation concealment
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: SERIOUS
rationales: Rated down by one level for imprecision as the CI includes both values suggesting no effect and values suggesting harm
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: LOW
No of participants: TCZ+MTX: 5/579 (0.9%) 
MTX monotherapy: 3/282 (1.1%) 
Effect: Relative Effect (95% CI): RR 0.81 (0.20 to 3.37)
Absolute Effect (95% CI): 2 fewer per 1,000 (from 9 fewer to 25 more)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with MTX-naïve and non-MTX csDMARDs exposed RA and moderate to high disease activity receive MTX monotherapy or boDMARD with MTX or tsDMARD with MTX?
Population: Patients with MTX-naïve and non-MTX csDMARDs exposed RA and moderate to high disease activity
Intervention: MTX monotherapy
Comparator: IL-6 Receptor Inhibitor + MTX
Outcome: Myocardial infarction (follow up: 1 year)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Rated down by one level for lack of allocation concealment
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: VERY_SERIOUS
rationales: Rated down by two levels for imprecision as the CI includes both values suggesting benefit and values suggesting harm
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: VERY LOW
No of participants: TCZ+MTX: 4/579 (0.7%)
MTX monotherapy: 0/282 (0.0%) 
Effect: Relative Effect (95% CI): RR 4.39 (0.24 to 81.28)
Absolute Effect (95% CI): 7 fewer per 1,000 (from 480 fewer to 160 more)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with MTX-naïve and non-MTX csDMARDs exposed RA and moderate to high disease activity receive MTX monotherapy or boDMARD with MTX or tsDMARD with MTX?
Population: Patients with MTX-naïve and non-MTX csDMARDs exposed RA and moderate to high disease activity
Intervention: MTX monotherapy
Comparator: IL-6 Receptor Inhibitor + MTX
Outcome: Death (follow up: 1 year)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Rated down by one level for lack of allocation concealment
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: SERIOUS
rationales: Rated down by one level for imprecision as the CI includes both values suggesting no effect and values suggesting harm
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: LOW
No of participants: TCZ+MTX: 6/579 (1.0%)  
MTX monotherapy: 2/282 (0.7%) 
Effect: Relative Effect (95% CI): RR 1.46 (0.30 to 7.19)
Absolute Effect (95% CI): 3 more per 1,000 (from 5 fewer to 44 more)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with MTX-naïve and non-MTX csDMARDs exposed RA and moderate to high disease activity receive MTX monotherapy or boDMARD with MTX or tsDMARD with MTX?
Population: Patients with MTX-naïve and non-MTX csDMARDs exposed RA and moderate to high disease activity
Intervention: MTX monotherapy
Comparator: IL-6 Receptor Inhibitor + MTX
Outcome: Malignancy (from SRs on harms)

Evidence assessment:
GRADE: result_interpretation: The Systematic Review RefID=4638, 2012 (RCTs=1, n=1190) comparing Tocilizumab + MTX vs Placebo + MTX among RA showed that for Cancer, the result was RR=4.4 (0.56-34.8) at 1 year and RR=0.41 (0.14-1.2) at 6 months (RCT=4, n=2950) 
Study design: Systematic Review
Guideline: 2021 ACR RA
Clinical question: Should patients with MTX-naïve and non-MTX csDMARDs naïve RA and moderate to high disease activity, receive long-term (≥ 3 months) low dose (≤ 10mg per day) GCs and mono- or combination csDMARDs or mono or combination csDMARDs alone?
Population: Patients with MTX-naïve and non-MTX csDMARDs naïve RA and moderate to high disease activity
Intervention: Mono or combination csDMARDs with long-term (≥ 3 months) low dose (≤ 10mg per day) GCs
Comparator: mono or combination csDMARDs alone (i.e. without long-term GCs)
Outcome: Disease activity (follow up: 2 years; assessed with: DAS28-ESR)
Importance: CRITICAL

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Downgraded by one level due to serious risk of bias. Patients, personnel, and outcome assessors of non-radiographic outcomes were not blinded. Patients, personnel, and outcome assessors of radiographic outcomes were blinded
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: NOT_SERIOUS
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: MODERATE
No of participants: csDMARDs + long-term low-dose GCs: 116
csDMARDs monotherapy: 126
Effect: Relative Effect (95% CI): -
Absolute Effect (95% CI): MD 0.5 lower (0.84 lower to 0.16 lower)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with MTX-naïve and non-MTX csDMARDs naïve RA and moderate to high disease activity, receive long-term (≥ 3 months) low dose (≤ 10mg per day) GCs and mono- or combination csDMARDs or mono or combination csDMARDs alone?
Population: Patients with MTX-naïve and non-MTX csDMARDs naïve RA and moderate to high disease activity
Intervention: Mono or combination csDMARDs with long-term (≥ 3 months) low dose (≤ 10mg per day) GCs
Comparator: mono or combination csDMARDs alone (i.e. without long-term GCs)
Outcome: Remission (follow up: 2 years; assessed with: DAS28-ESR<2.6)
Importance: CRITICAL

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Downgraded by one level due to serious risk of bias. Patients, personnel, and outcome assessors of non-radiographic outcomes were not blinded. Patients, personnel, and outcome assessors of radiographic outcomes were blinded
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: NOT_SERIOUS
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: MODERATE
No of participants: csDMARDs + long-term low-dose GCs: 64/116 (55.2%)
csDMARDs monotherapy: 41/126 (32.5%)
Effect: Relative Effect (95% CI): RR 1.70 (1.26 to 2.29)
Absolute Effect (95% CI): 228 more per 1,000 (from 85 more to 420 more)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with MTX-naïve and non-MTX csDMARDs naïve RA and moderate to high disease activity, receive long-term (≥ 3 months) low dose (≤ 10mg per day) GCs and mono- or combination csDMARDs or mono or combination csDMARDs alone?
Population: Patients with MTX-naïve and non-MTX csDMARDs naïve RA and moderate to high disease activity
Intervention: Mono or combination csDMARDs with long-term (≥ 3 months) low dose (≤ 10mg per day) GCs
Comparator: mono or combination csDMARDs alone (i.e. without long-term GCs)
Outcome: Radiographic progression (follow up: 2 years; assessed with: Sharp/van der Heijde score)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: NOT_SERIOUS
rationales: Downgraded by one level due to serious risk of bias. Patients, personnel, and outcome assessors of non-radiographic outcomes were not blinded. Patients, personnel, and outcome assessors of radiographic outcomes were blinded
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: SERIOUS
rationales: Downgraded by one level due to serious imprecision. Confidence interval includes both values suggesting benefit and values suggesting no effect
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: MODERATE
No of participants: csDMARDs + long-term low-dose GCs: 108
csDMARDs monotherapy: 117
Effect: Relative Effect (95% CI): -
Absolute Effect (95% CI): MD 3.9 lower (7 lower to 0.8 lower)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with MTX-naïve and non-MTX csDMARDs naïve RA and moderate to high disease activity, receive long-term (≥ 3 months) low dose (≤ 10mg per day) GCs and mono- or combination csDMARDs or mono or combination csDMARDs alone?
Population: Patients with MTX-naïve and non-MTX csDMARDs naïve RA and moderate to high disease activity
Intervention: Mono or combination csDMARDs with long-term (≥ 3 months) low dose (≤ 10mg per day) GCs
Comparator: mono or combination csDMARDs alone (i.e. without long-term GCs)
Outcome: Disability (follow up: 2 years; assessed with: HAQ Swedish version)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Downgraded by one level due to serious risk of bias. Patients, personnel, and outcome assessors of non-radiographic outcomes were not blinded. Patients, personnel, and outcome assessors of radiographic outcomes were blinded
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: SERIOUS
rationales: Downgraded by one level due to serious imprecision. Confidence interval includes both values suggesting benefit and values suggesting no effect
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: LOW
No of participants: csDMARDs + long-term low-dose GCs: 116
csDMARDs monotherapy: 126
Effect: Relative Effect (95% CI): -
Absolute Effect (95% CI): MD 0.2 lower (0.34 lower to 0.06 lower)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with MTX-naïve and non-MTX csDMARDs naïve RA and moderate to high disease activity, receive long-term (≥ 3 months) low dose (≤ 10mg per day) GCs and mono- or combination csDMARDs or mono or combination csDMARDs alone?
Population: Patients with MTX-naïve and non-MTX csDMARDs naïve RA and moderate to high disease activity
Intervention: Mono or combination csDMARDs with long-term (≥ 3 months) low dose (≤ 10mg per day) GCs
Comparator: mono or combination csDMARDs alone (i.e. without long-term GCs)
Outcome: Withdrawal due to adverse events (follow up: 2 years)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Downgraded by one level due to serious risk of bias. Patients, personnel, and outcome assessors of non-radiographic outcomes were not blinded. Patients, personnel, and outcome assessors of radiographic outcomes were blinded
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: VERY_SERIOUS
rationales: Downgraded by two levels due to very serious imprecision. Confidence interval includes both values suggesting benefit and values suggesting harm
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: VERY LOW
No of participants: csDMARDs + long-term low-dose GCs: 26/116 (22.4%)
csDMARDs monotherapy: 24/126 (19.0%)
Effect: Relative Effect (95% CI): RR 1.18 (0.72 to 1.93)
Absolute Effect (95% CI): 34 more per 1,000 (from 53 fewer to 177 more)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with MTX-naïve and non-MTX csDMARDs naïve RA and moderate to high disease activity, receive long-term (≥ 3 months) low dose (≤ 10mg per day) GCs and mono- or combination csDMARDs or mono or combination csDMARDs alone?
Population: Patients with MTX-naïve and non-MTX csDMARDs naïve RA and moderate to high disease activity
Intervention: Mono or combination csDMARDs with long-term (≥ 3 months) low dose (≤ 10mg per day) GCs
Comparator: mono or combination csDMARDs alone (i.e. without long-term GCs)
Outcome: Death (follow up: 2 years)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Downgraded by one level due to serious risk of bias. Patients, personnel, and outcome assessors of non-radiographic outcomes were not blinded. Patients, personnel, and outcome assessors of radiographic outcomes were blinded
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: VERY_SERIOUS
rationales: Downgraded by two levels due to very serious imprecision. Very low number of events
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: VERY LOW
No of participants: csDMARDs + long-term low-dose GCs: 1/116 (0.9%)
csDMARDs monotherapy: 0/126 (0.0%)
Effect: Relative Effect (95% CI): RR 3.26 (0.13 to 79.15)
Absolute Effect (95% CI): 0 fewer per 1,000 (from 0 fewer to 0 fewer)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with MTX-naïve and non-MTX csDMARDs naïve RA and moderate to high disease activity, receive long-term (≥ 3 months) low dose (≤ 10mg per day) GCs and mono- or combination csDMARDs or mono or combination csDMARDs alone?
Population: Patients with MTX-naïve and non-MTX csDMARDs naïve RA and moderate to high disease activity
Intervention: Mono or combination csDMARDs with long-term (≥ 3 months) low dose (≤ 10mg per day) GCs
Comparator: mono or combination csDMARDs alone (i.e. without long-term GCs)
Outcome: Death (age-adjusted) (follow up: 10 years)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Downgraded by one level due to serious risk of bias. Patients, personnel, and outcome assessors of non-radiographic outcomes were not blinded. Patients, personnel, and outcome assessors of radiographic outcomes were blinded
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: VERY_SERIOUS
rationales: Downgraded by two levels due to very serious imprecision. Confidence interval includes both values suggesting benefit and values suggesting harm
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: VERY LOW
No of participants: csDMARDs + long-term low-dose GCs: 119 participants(-)
csDMARDs monotherapy: 111 participants(8.1%)
Effect: Relative Effect (95% CI): HR 1.60 (0.61 to 4.18)
Absolute Effect (95% CI): 45 more per 1,000 (from 31 fewer to 216 more)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with MTX-naïve and non-MTX csDMARDs naïve RA and moderate to high disease activity, receive long-term (≥ 3 months) low dose (≤ 10mg per day) GCs and mono- or combination csDMARDs or mono or combination csDMARDs alone?
Population: Patients with MTX-naïve and non-MTX csDMARDs naïve RA and moderate to high disease activity
Intervention: Mono or combination csDMARDs with long-term (≥ 3 months) low dose (≤ 10mg per day) GCs
Comparator: mono or combination csDMARDs alone (i.e. without long-term GCs)
Outcome: Composite Cardiovascular events (age-adjusted) (follow up: 10 years)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: SERIOUS
rationales: Downgraded by one level due to serious risk of bias. Patients, personnel, and outcome assessors of non-radiographic outcomes were not blinded. Patients, personnel, and outcome assessors of radiographic outcomes were blinded
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: SERIOUS
rationales: Downgraded by two levels due to very serious imprecision. Confidence interval includes both values suggesting benefit and values suggesting harm
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: LOW
No of participants: csDMARDs + long-term low-dose GCs: 119 participants(-)
csDMARDs monotherapy: 111 participants(13.5%)
Effect: Relative Effect (95% CI): HR 1.8 (0.9 to 3.6)
Absolute Effect (95% CI): 95 more per 1,000 (from 13 fewer to 272 more)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with MTX-naïve and non-MTX csDMARDs exposed RA and moderate to high disease activity, receive long-term (≥ 3 months) low dose (≤ 10mg per day) GCs and mono- or combination csDMARDs or mono or combination csDMARDs alone?
Population: Patients with MTX-naïve and non-MTX csDMARDs exposed RA and moderate to high disease activity
Intervention: Mono or combination csDMARDs with long-term (≥ 3 months) low dose (≤ 10mg per day) GCs
Comparator: mono or combination csDMARDs alone (i.e. without long-term GCs)
Outcome: Disability (follow up: 2 years; assessed with: HAQ)
Importance: IMPORTANT

Evidence assessment:
GRADE: Risk of bias: result: NOT_SERIOUS
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: VERY_SERIOUS
rationales: Downgraded by two levels due to very serious imprecision. Confidence interval includes both values suggesting no effect and values suggesting harm. Small sample size.
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: LOW
No of participants: csDMARDs + long-term low-dose GCs: 77
csDMARDs monotherapy: 74
Effect: Relative Effect (95% CI): -
Absolute Effect (95% CI): MD 0.22 higher (0.02 lower to 0.46 higher)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio
Guideline: 2021 ACR RA
Clinical question: Should patients with RA initiating MTX receive oral MTX or subcutaneous (SC) MTX?
Population: Patients with RA initiating MTX
Intervention: Oral MTX
Comparator: SC MTX
Outcome: Disease Activity (follow up: 4 months; assessed with: ACR 20)
Importance: CRITICAL

Evidence assessment:
GRADE: Risk of bias: result: NOT_SERIOUS
rationales: The study did not report on whether allocation was concealed.
Inconsistency: result: NOT_SERIOUS
Indirectness: result: NOT_SERIOUS
Imprecision: result: SERIOUS
rationales: Downgraded by one level due to serious imprecision. Confidence intervals includes both values suggesting no effect and values suggesting benefit.
Other considerations: result: none
Study design: Randomized Controlled Trial
Certainty: MODERATE
No of participants: SC MTX: 160/188 (85.1%)
Oral MTX: 144/187 (77.0%)
Effect: Relative Effect (95% CI): RR 1.11 (1.00 to 1.22)
Absolute Effect (95% CI): 85 more per 1,000 (from 0 fewer to 169 more)
Abbreviations: CI: Confidence interval; RR: Risk ratio; MD: Mean difference; HR: Hazard Ratio