According to observations from a follow-up study of the RACAT trial looking at patients with rheumatoid arthritis who have suboptimal responses to methotrexate, triple therapy with methotrexate, sulfasalazine and hydroxychloroquine is more durable than combined methotrexate–etanercept therapy. Of the 289 patients followed up, 78% remained on triple therapy at 1 year compared with 63% who remained on methotrexate–etanercept therapy; significantly more patients changed from methotrexate–etanercept therapy to triple therapy than vice versa (P = 0.005).