Effect of Proactive Therapeutic Drug Monitoring on Maintenance of Sustained Disease Control in Adults With Rheumatoid Arthritis on a Subcutaneous TNF Inhibitor: The Rheumatoid Arthritis Therapeutic DRUg Monitoring Trial (RA-DRUM)

Inclusion Criteria:

1. A clinical diagnosis of RA

2. ≥ 18 and under 75 years of age at screening

3. On stable therapy with standard dose of a SC TNFi (adalimumab) for a minimum of 3months and a maximum of 24 months

4. In low disease activity or remission (DAS28-CRP under 3.2) and indication forcontinuation of treatment according to the treating physician

5. Subject capable of understanding and signing an informed consent form

Exclusion Criteria:

1. Major comorbidities, such as previous malignancies within the last 5 years,uncontrolled diabetes mellitus, severe infections (including HIV), uncontrollablehypertension, severe cardiovascular disease (NYHA class 3 or 4), severe respiratorydiseases, demyelinating disease, significant chronic widespread pain syndrome,significant renal or hepatic disease, and/or other diseases or conditions whicheither contraindicate treatment with SC TNFi or make adherence to the protocoldifficult

2. Hypersensitivity to sc TNFi (adalimumab).

3. Pregnancy, or subject considering becoming pregnant during the study period

4. Psychiatric or mental disorders, alcohol abuse or other substance abuse, languagebarriers, or other factors that makes adherence to the study protocol difficult

5. Changes in csDMARD co-medication, including dose changes of csDMARD or changes inthe dose of corticosteroids within the last 2 months

6. Co-medication with bDMARD, tsDMARD, or other immunosuppressive drugs (excludingcsDMARD and corticosteroids ≤ 7.5 mg prednisolone (or equivalent) once daily).

7. Active participation in any other interventional study.

8. In need of live vaccines during the study period.