Efficacy of a Sequential Treatment Strategy in Rheumatoid Arthritis

To join this study, you need to be an adult, aged 18 or older, and have rheumatoid arthritis that has been confirmed by doctors. Your RA must also be considered 'ACPA positive', which is a type of antibody found in your blood that’s common in RA. You must currently be taking methotrexate or leflunomide for at least three months, but these medications aren't fully controlling your RA, meaning you still have some ongoing inflammation.

It's important that you haven't taken other advanced biologics or targeted synthetic medicines for RA before. The study also requires you to have a clear reason why your doctor would typically recommend starting a TNF inhibitor. There are also reasons why you might not be able to join, such as if you have certain heart conditions, untreated tuberculosis, or if you can't commit to all the study visits for 48 weeks. Pregnant or breastfeeding women, or women who could become pregnant and aren't using effective birth control, also cannot participate.

If you decide to take part, the study will last for 48 weeks. You'll be randomly assigned to one of two groups: either you'll start with a TNF inhibitor medicine for 12 weeks and then switch to abatacept for the next 36 weeks, or you'll continue with a TNF inhibitor. You will have regular appointments at the clinic for assessments, which will include blood tests and checks of your RA symptoms and how you're feeling. These visits are important for the doctors to monitor your progress and ensure your safety throughout the study.