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Discontinuation was greater in Triple patients referent to TNF/MTX (adjusted HR 2.17 [aHR], 95%CI 1.63-2.88 in biologic-naïve; aHR=1.51, 95%CI 1.06-2.15 in biologic-experienced). In biologic-naïve patients at 6 months, the proportion attaining low disease activity (TNF/MTX49.2% vs. Triple33.3% respectively) was significantly greater in the MTX/TNF group, as was mean change in CDAI (-9.3 vs. -5.5 units, 95% CI -1.5 to -6.1). Corresponding results in biologic-experienced patients numerically favored MTX/TNF over Triple but were not signi