Clinical responses over time. Clinical responses over time. Patients in the initial combination therapy group received adalimumab 40 mg eow + MTX throughout the study and patients in the delayed combination therapy group received placebo + MTX during Year 1. After Year 1 (vertical broken line), all patients received open-label adalimumab 40 mg eow + MTX. A. Mean patient’s assessment of pain (mm). B. Mean patient’s global assessment (mm). C. Mean physician’s global assessment (mm). D. Mean CRP (mg/dl). Statistically significant **p < 0.01 and *p < 0.05 for differences between initial and delayed combination therapy groups from generalized estimating equations. NS (nonsignificant) indicates p ≥ 0.05. ADA: adalimumab; MTX: methotrexate; CRP: C-reactive protein. Edward C. Keystone et al. J Rheumatol 2013;40:1487-1497 ©2013 by The Journal of Rheumatology