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Objective. To evaluate two monotherapies followed by step‐up combination therapy with two or three complementary drugs in active rheumatoid arthritis (RA) in comparison with sulphasalazine (SSZ) alone.

Methods. One hundred and twenty‐six consecutive patients with early active RA were enrolled in this open controlled clinical trial. The primary end‐point was 50% improvement according to the ACR criteria (ACR50) at 6, 12 or 18 months. The secondary end‐points were a full response (Magnusson criteria) and/or remission (ACR criteria) at 3 yr. Methotrexate (MTX) (group 1), cyclosporin A (CsA) (group 2) or SSZ (group 3) was used first. After 6 months, a combination of two drugs (CsA and MTX) was employed in groups 1 and 2. SSZ was added after 12 months if improvement was less than ACR50 with the combination. Group 3 continued with SSZ alone.

Results. After 6 …