OBJECTIVES: Tofacitinib is a new oral drug which has demonstrated efficacy and safety in pivotal clinical trials. This study sough to assess the efficacy of tofacitinib in combination with methotrexate compared with biological DMARDs in combination with methotrexate, in rheumatoid arthritis (RA) patients with an inadequate response to methotrexate. METHODS: We performed an analysis of systematic review published in the last five years that assessed biological DMARDs (Adalimumab, certolizumab, infliximab, etanercept, golimumab, tocilizumab, rituximab and abatacept) or tofacitinib to treatment of RA after inadequate response to methotrexate. The search was realized in the database of Medline, EMBASE, Cochrane, LILACS, DARE and HTA. The data collection was realized by two researchers independently. Clinical trials that had been included in the systematic reviews were extracted and evaluated their methodological quality with checklist Cochrane. With mixed treatment comparison, the effectiveness between biological DMARDs and tofacitinib was compared using methotrexate as a common comparator. The outcomes considered in terms of effectiveness were improvement rates by ACR20, ACR50, ACR70 and HAQ criteria at 12 and 24 weeks. In order to evaluate the impact of heterogeneity, we performed analysis of sensibility and subgroups. RESULTS: