Evaluation of SC Injected Tc 99m Tilmanocept Localization in Active RA Subjects by SPECT and SPECT/CT Imaging

Inclusion Criteria:

- The subject has provided written informed consent with HIPPA authorization before the
initiation of any study-related procedures.

CONTROLS:

- The subject is between 21-45 years of age at the time of consent.

- The subject has not experienced joint pain for at least 4 weeks prior to the consent
date and is deemed to be clinically free of any inflammatory disease(s).

ACTIVE RHEUMATOID ARTHRITIS

- The subject is at least 21 years of age at the time of consent.

- The subject has moderate to severe RA, based on either the 1987American College of
Rheumatology (ACR) score of ≥ 4/7 or the 2010 ACR/EULAR score of ≥ 6/10.

- The subject has a DAS28 of >4.4 (using the ESR).

- If the subject is on methotrexate, they have been at a stable dose for > 4 weeks
prior to the screening visit.

- If the subject is on biologic therapy, they have been at a stable dose > 8 weeks
prior to the screening visit.

- If the subject is on NASIDS or oral corticosteroids, it is ≤ 10mgmg/day or
equivalent, and has been at a stable dose for > 4 weeks prior to the screening visit.

Exclusion Criteria:

- The subject is pregnant or lactating.

- BMI >32.0.

- The subject has had or is currently receiving chemotherapy for a non-inflammatory
related condition or radiation therapy.

Chronic or persistent infection or has any condition that would, in the opinion of the
examining physician, preclude their participation.

- The subject has a known allergy to or has had a reaction to dextran exposure.

- The subject has received an investigational product within 30 days prior to he Tc99m
tilmanocept administration.

- The subject has received any radiopharmaceutical within 7 radioactive half-lives of
that radiopharmaceutical prior to the administration of Tc 99m tilmanocept.