Fig. 1

Flowchart depicting the study cohort. MTX methotrexate, RA rheumatoid arthritis, nbDMARD nonbiologic disease-modifying antirheumatic drug. *Prior or current use of methotrexate only as nonbiologic DMARD. **Prior or current use of 2 or more nonbiologic DMARDS. ***For the MTX monotherapy group, limited to patients seen with moderate disease activity and poor prognosis or high disease activity and seen by a physician (not a midlevel provider) at both visits. For the multiple nonbiologic DMARD group, included only those patients with moderate or high disease activity seen by a physician (not a midlevel provider) at both visits