RA-PROPR

The purpose of the study is to assess whether the addition of a TNFi-biologic (tumor necrosis factor inhibitor) medication to methotrexate (MTX) is superior to adding a targeted synthetic DMARD (disease-modifying anti-rheumatic) medication to MTX for people with active RA despite current MTX treatment.

Inclusion Criteria

1. Patients with active, disabling RA despite the use of methotrexate ≥3 months
2. If receiving glucocorticoids or NSAIDs, on stable doses for ≥2 weeks
3. Insurance plan allows access to at least 1 drug in each of the two treatment strategies, TNFi-biologic vs. tsDMARD

Exclusion Criteria

1. Use of leflunomide, sulfasalazine, cyclosporine, or azathioprine within 2 months
2. Prior treatment with a TNFi-biologic, non-TNFi biologic, or targeted synthetic DMARD
3. History of HIV 

Study Requirements

This study involves up to 6 regularly scheduled clinic visits to Tufts over the course of 12 months. We will collect information about symptoms. At each visit, blood (about 2 teaspoons) and a urine sample will be collected. Patients will receive compensation for their time for study participation, $60 at the baseline visit and $50 for each subsequent visit.