Novel Imaging Markers for Rheumatoid Arthritis

The inclusion criteria for all patients to be enrolled are:

- RA by 2010 ACR classification criteria

- Age ≥ 18 years at enrollment

- Ability to give consent and follow the study protocol

- Prednisone permitted in doses ≤10 mg daily

- Women of reproductive potential must agree to use an acceptable method of birth
control during treatment

Additional inclusion criteria for group I:

- DAS28 ≤ 3.2 during the last 2-months prior to the baseline visit

- On MTX at a stable dose for > 8 weeks prior to the baseline visit

- No biologic therapy during the past 6-months prior to the baseline visit

- No anticipated biologic therapy

Additional inclusion criteria for group II:

- DAS28 > 3.2

- No biologic therapy during the past 6-months prior to the baseline visit

- Scheduled to initiate anti-TNF therapy using CIMZIA

Exclusion Criteria for all patients to be enrolled are:

- Any psychiatric disorder that prevents the subject from providing informed consent

- Inability or unwillingness to follow the protocol

- Estimated glomerular filtration rate (eGFR, calculated based on serum creatinine) < 60
ml/min/1.72m2

- Known allergy or hypersensitivity to any study products (including gadolinium)

- History of injury or surgery of the wrist and hand to be scanned

- Inability to place non-dominant hand appropriately for imaging

- History of claustrophobia; inability to tolerate MRI and other contraindication of MRI

- Pregnancy or breast-feeding

- Diabetes mellitus requiring insulin therapy

- Prednisone dose > 10 mg/day (or equivalent dose of another corticosteroid) within 1
month of baseline visit

- Any investigational agent within the earlier of 4 weeks or 5 half-lives prior to
randomization

- Any biologic therapy within 6-month prior to the baseline visit

- Any condition or treatment, which in the opinion of the investigator, places the
subject at an unacceptable risk as a participant in the study

Additional exclusion criteria for Group II:

- Chronic or persistent infection including but not limited to human immunodeficiency
virus [HIV], hepatitis B, hepatitis C, listeriosis, TB, or other opportunistic
infection)

- Active infection or severe infections requiring hospitalization or treatment with
intravenous (IV) antibiotics, IV antivirals, or IV antifungals within 30 days prior to
baseline visit, or oral antibiotics, oral antivirals, or oral antifungals within 14
days prior to baseline visit

- Receipt of a live vaccine within 4 weeks prior to baseline visit

- History of malignancy within the past 5 years other than treated localized carcinoma
in situ of the cervix or adequately treated non-metastatic squamous or basal cell skin
carcinoma