According to a report from MedPage Today, a novel combination of a steroid and tumor necrosis factor (TNF) inhibitor may be just as effective at treating patients with rheumatoid arthritis as adalimumab. In a phase IIa trial—the results of which were published by Buttgereit et al in Arthritis & Rheumatology—the researchers discovered that after 12 weeks, 31 patients taking the combination saw reductions in their 28-joint Disease Activity Score with C-reactive protein of 2.65 points compared with reductions of 2.13 points among the 242 patients who took adalimumab. Working by gravitating toward activated immune cells with expressed TNF to limit exposure to the steroid and reduce the adverse effects associated with long-term steroid use, the combination was administered to patients with rheumatoid arthritis at 100-mg doses intravenously alternated with a placebo injection every other week, as well as to a control group who received 80-mg doses of the placebo intravenously alternated with the active drug every other week. Despite showing lower disease activity scores after 12 weeks, among those who took the combination, only 52% demonstrated a 50% decline in symptoms compared with 65% of those who took adalimumab. The researchers concluded that with minimal side effects and a greater demonstrated capability of reducing disease activity, the combination had a probability of superiority to adalimumab of 79.3% to 99.5%. Investigators are currently conducting a phase II trial with a modified version of the combination to determine its efficacy—and expect to report their findings this year.