The primary objective is to compare the benefits and harms of different disease-modifying anti-rheumatic drugs (DMARDs) as initial therapy and after failure of conventional synthetic DMARDs or biologic or targeted synthetic DMARDs in adults with rheumatoid arthritis through a network meta-analysis (NMA). A secondary objective is to rank the interventions for both benefits and harms.

This protocol describes the approach for separate NMAs for the three populations of interest (described below), which we intend to publish as three separate Cochrane Reviews.

1) Disease-modifying anti-rheumatic drugs for rheumatoid arthritis as initial therapy: a systematic review and network meta-analysis

2) Disease-modifying anti-rheumatic drugs for rheumatoid arthritis after failure of conventional synthetic disease-modifying anti-rheumatic drugs: a systematic review and network meta-analysis

3) Disease-modifying anti-rheumatic drugs for rheumatoid arthritis after failure of biologic or targeted synthetic therapy: a systematic review and network meta-analysis