Comparable effect of MTX and placebo on pain, functional disability, joint damage progression vs. placeboJoints with space loss appeared to be eroding less in the MTX group compared to the placebo group. Only serum IL-6 level and presence of synovitis at inclusion (but not pain, sex, age adipokines) were associated with a higher risk of erosive evolution in the non-erosive joints using the GUSS score at 12 months in the entire population. Here, IL6 is linked to synovitis.