A Study of Tocilizumab in Comparison to Etanercept in Participants With Rheumatoid Arthritis and Cardiovascular Disease Risk Factors

Inclusion Criteria:

• Participants with moderate to severe RA of greater than or equal to (>=6) monthsduration

• Inadequate response to at least one non-biologic DMARD

• Positive for Rheumatoid Factor (RF) and/or anti-cyclic citrullinated peptide (CCP)antibodies at screening

• Have C-reactive protein (CRP) greater than (>) 0.3 milligrams per deciliter (mg/dL) atscreening or at the baseline visit

• Swollen joint count (SJC) >=8 (66 joint count) and tender joint count (TJC) >= 8 (68joint count) during screening or at the baseline visit

• History of Coronary Heart Disease (CHD) or presence of one or more additional CHD riskfactors, including current cigarette smoking, hypertension, low High DensityLipoprotein (HDL) cholesterol, family history of premature CHD, diabetes, presence ofextra-articular disease associated with rheumatoid arthritis

• At the time of randomization, will have discontinued infliximab, adalimumab,golimumab, or certolizumab for >= 4 weeks

Exclusion Criteria:

• Major surgery (including joint surgery or coronary revascularization) within 8 weeksprior to screening or planned major surgery within 1 year of study start

• Rheumatic autoimmune disease other than RA

• History of or current inflammatory joint disease other than RA

• Current or recent (within past 3 months) evidence of serious uncontrolled concomitantcardiovascular or cerebrovascular disease (myocardial infarction, revascularization,stroke, transient ischemic attack, or acute coronary syndrome)

• Current or previous (within the past 2 years) evidence of serious uncontrolledconcomitant pulmonary (including obstructive pulmonary disease), renal, hepatic,endocrine (including uncontrolled diabetes mellitus) or gastrointestinal disease

• Uncontrolled disease states, such as asthma or inflammatory bowel disease where flaresare commonly treated with oral or parenteral corticosteroids

• Pre-existing central nervous system demyelinating or seizure disorders

• History of diverticulitis, diverticulosis requiring treatment or other lowergastrointestinal tract conditions that might predispose to perforations

• Current liver disease as determined by the investigator; a history of asymptomaticelevations in liver function tests (LFTs) is not considered an exclusion

• Active current infection or history of recurrent bacterial, viral, fungal,mycobacterial or other infections, including but not limited to tuberculosis andatypical mycobacterial disease, hepatitis B and C, and herpes zoster, but excludingfungal infections of nail beds

• Any major episode of infection requiring hospitalization or treatment with IVantibiotics within four weeks of screening or oral antibiotics within two weeks priorto screening visit

• Active tuberculosis (TB) requiring treatment within 3 years prior to baseline

• Latent TB diagnosed during screening that has not been appropriately treated

• Primary or secondary immunodeficiency (history of or currently active)

• Moderate to severe heart failure

• Evidence of active malignant disease, malignancies diagnosed within the previous 10years (including hematologic malignancies and solid tumors, except basal cellcarcinoma of the skin that has been excised and cured), or breast cancer diagnosedwithin the previous 20 years

• Breast feeding mothers

• History of alcohol, drug or chemical abuse within the 6 months prior to screening

• Participants with lack of peripheral venous access

• Participants with a history of allergic reactions to latex

• Previous treatment with non-tumor necrosis factor (non-TNF)-inhibitor biologic therapy

• Treatment with any investigational agent within 4 weeks of screening visit

• Treatment with any cell depleting therapies within 1 year of baseline

• Treatment with IV gamma globulin, plasmapheresis or Prosorba column within 6 months ofbaseline visit

• Immunization with a live/attenuated vaccine within 4 weeks prior to baseline visit

• Any previous treatment with alkylating agents, such as cyclophosphamide orchlorambucil, or with total lymphoid irradiation