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The value of intensive combination therapy in early rheumatoid arthritis is unproven. In a multicentre, double-blind, randomised trial (COBRA), we compared the combination of sulphasalazine (2 g/day), methotrexate (7·5 mg/week), and prednisolone (initially 60 mg/day, tapered in 6 weekly steps to 7·5 mg/day) with sulphasalazine alone. 155 patients with early rheumatoid arthritis (median duration...