Cassandra from Alberta asks: Why aren’t biologics used first to treat rheumatoid arthritis?

While biologics can be very effective at treating rheumatoid arthritis, they typically are not considered the first choice.  In most cases, methotrexate remains the gold standard treatment.  This is not just because it costs less, but in fact, when studied head to head, methotrexate works just as well as biologics do.  When combined together, methotrexate and biologics are more effective.  Overall, methotrexate is likely a safer option compared to biologics; and, well over 50% of individuals will go into remission on traditional DMARDs like methotrexate without needing biologic medications.

Posted: August 3, 2026

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