Key PointsQuestionAre biosimilars of adalimumab, etanercept, and infliximab associated with equivalent treatment compared with their reference biologic drugs for the management of rheumatoid arthritis?FindingsIn this systematic review and meta-analysis of 25 randomized clinical trials that included data on 10 642 patients with rheumatoid arthritis, patients using biosimilars had equivalent clinical responses and functional capacity compared with patients using reference biologic drugs.MeaningThese findings suggest that biosimilars may yield therapeutically equivalent outcomes compared with reference biologic drugs for the management of rheumatoid arthritis.