CRD Summary: This review assessed the efficacy and safety of the treatment of early rheumatoid arthritis with infliximab. The authors concluded that infliximab in combination with methotrexate was more efficacious than methotrexate alone. Due to shortcomings in the review, this conclusion may not be reliable.

CRD Commentary: The review question was clear and was supported by appropriate inclusion criteria. A thorough search for studies was undertaken, with no restrictions based on language. Attempts were made to identify unpublished data. The methods used for study selection and data extraction were not reported, so it is unclear whether methods were used to reduce error and bias. There was no assessment of the methodological quality of the included studies. Also, the authors did not report any formal assessment of between study heterogeneity. Although the authors' conclusions were supported by the evidence presented, they may not be reliable due to the poor reporting of a number of aspects of the review, the potential study heterogeneity and the lack of validity assessment.