Rheumatoid Arthritis Treatment After First Anti-TNF INvestiGation

Inclusion Criteria:

• Age ≥18 years at the time of signing the informed consent form and either male orfemale.
• Diagnosis of RA according to the 1987 ACR classification criteria OR 2010 ACR/EULARclassification criteria at least 6 months prior to screening.
• Patients with persistent RA disease activity whilst being treated with an initial TNFiagent on a background MTX up to 20-25 mg/week for at least 12 weeks defined accordingto SIR and EULAR guidelines as: primary non-response: failing to improve DAS28 by ≥ 1.2 or failing to achieve DAS28 ≤ 3.2 within the first three to six months of startingthe initial TNFi; secondary non-response: determined by physician decision withevidence of flare and deterioration in DAS28 of ≥ 1.2.
• Methotrexate (MTX) dose stable for 28 days prior to screening.
• Patients on NSAIDs and / or corticosteroids must remain on an unchanged regimen for atleast 28 days prior to study drug administration.
• The patient must be able to comply with the study visit schedule and other protocolrequirements.
• The patient understands the purpose of the study and is able and willing to sign theinformed consent form, according to ICH/GCP.
• Signed written informed consent for biological analysis.
• Female patients with reproductive potential must have a negative serum pregnancy testwithin 7 days prior to start of trial. Women of childbearing potential and malepatients must be willing to practice acceptable methods of contraception duringtreatment and for 6 months (female patients) and 3 months (male patients) afterdiscontinuation of treatment.

Exclusion Criteria:

• Patients who have previously received more than 1 TNFi drug OR any other biologicaltherapy.
• Patients with inflammatory joint disease of different origin or any arthritis withonset prior to 16 years of age.
• Patients taking any disease-modifying antirheumatic drug (DMARDs) (e.g. all exceptmethotrexate). Discontinuation must occur at least 28 days prior to study treatmentstart.
• History or presence of other disease, metabolic dysfunction, physical examinationfinding, or clinical laboratory finding giving reasonable suspicion of a disease orcondition that contraindicates the use of an investigational drug.
• Known hypersensitivity to any active substance or excipients of study drug.
• Pregnancy or breast feeding.