Discovering the Antecedents of Rheumatoid Arthritis Flare

80% of patients living with rheumatoid arthritis can expect fluctuations in their symptoms
over time. Dramatic increases in disease activity are considered flare. This study will
follow patients with increased risk for flare prospectively for one year. Serial
questionnaires and disease activity scores will be compared to blood samples to better
understand the molecular phenotype of rheumatoid arthritis flares.

Inclusion Criteria:

- 2010 criteria for Rheumatoid Arthritis

- Swelling of at least one joint and or elevated acute phase reactants

- Greater than or equal to 40 years old or less than or equal to 65 year old female sex

- cyclic citrullinated peptide antibody + in the past 12 months

Exclusion Criteria:

- hemoglobin < 9

- white blood cell count < 3.5

- Diagnosis of any active malignancy within the last 3 years besides non-melanomatous
skin cancer

- Diagnosis of diabetes and requires insulin

- HIV+, Hep B S Ag+, Hep C polymerase chain reaction +

- Untreated latent tuberculosis

- Diagnosis of any additional systemic autoimmune connective tissue disease

- Inability to reliably complete study requirements

- History, physical, social or laboratory findings suggestive of any other medical or
psychological condition that would, in the opinion of the principal investigator, make
the candidate ineligible for the study