OBJECTIVES: Head to head data from randomized controlled trials (RCTs) comparing biologic monotherapies is limited. Our objective was to compare PROs for tocilizumab monotherapy vs. other approved biologic monotherapies, in DMARD-IR RA patients, based on currently available RCT evidence. METHODS: Full-text publications of RCTs that assessed tocilizumab, and other biologic therapies, as monotherapy in DMARD-IR patients were identified through a systematic literature review. RCTs reporting data on PROs (Health Assessment Questionnaire Disability Index (HAQ-DI), pain VAS, patient global assessment of disease activity  (PGA) VAS, SF-36, or fatigue) at 24 weeks were included. Where sufficient data was available, Bayesian network meta-analyses was used to obtain treatment effect estimates between included interventions. It was assumed that the effects of the aTNF treatments were exchangeable, and data for the assessed aTNFs were pooled to give a single, more stable estimate. RESULTS: Four studies were identified that formed a network comparing monotherapy treatments (tocilizumab and aTNFs (adalimumab, etanercept, certolizumab pegol)) and reported PRO data. Data on pain VAS, PGA VAS, and HAQ-DI was most commonly reported. Tocilizumab monotherapy showed greater improvement in pain [Difference -11.38 (95% CrI -18.40, -4.32)] and PGA [Difference -10.49 (95% CrI -17.68, -3.24)] compared to the assessed aTNF monotherapies. Tocilizumab monotherapy showed greater improvement in HAQ-DI [Difference -0.52 (95% CrI -0.73, -0.31)] compared with placebo, and was at least as efficacious compared to aTNF monotherapy [Difference -0.16 (95% CrI -0.33, 0.01)]. Insufficient data was reported for the SF-36 and fatigue to allow network meta-analysis. CONCLUSIONS: Based on network meta-analysis of currently available RCT evidence, involving indirect comparison of trial findings, tocilizumab monotherapy was found to have better outcomes than assessed aTNF monotherapies in terms of patient reported pain and disease activity in a DMARD-IR RA population. Tocilizumab was at least as efficacious as aTNF agents in improvement in physical function.