A multicenter, randomized, open-label, blinded-assessor, phase 4 study in patients with early rheumatoid arthritis to compare active conventional therapy versus three biologic treatments, and two de-escalation strategies in patients who respond to treatment.

1. Subject is >=18 years of age., 2. Subject has a diagnosis of RA as defined by
the newly established ACR/EULAR criteria, 2010 (Appendix D). (Patients should
also be classified according to the 1987-revised ACR-classification criteria,
without this being an inclusion criteria) (Appendix C)., 3. <24 months from
arthritis symptom debut (symptom duration will be registered)., 4. Subject must
have DAS28 (CRP) > 3.2., 5. >= 2 swollen joints AND >= 2 tender joints., 6.
Subject must fulfill one of the following three criteria: RF positive OR ACPA
positive OR CRP >=10 mg/L., 7. Female subject is either not of childbearing
potential (postmenopausal, surgically sterile etc.), or is of childbearing
potential and practicing one of the following methods of birth control
throughout the study and for 150 days after study completion:
• Intrauterine device (IUD)
• Contraceptives (oral, parenteral, patch) for three months prior to study drug
administration)
• A vasectomized partner
8. Female subjects of childbearing potential must have a negative serum
pregnancy test at the Screening visit., 9. Subject is judged to be in good
general health as determined by the principal investigator based upon the
results of medical history, laboratory profile, physical examination, chest
X-ray (CXR), and 12-lead electrocardiogram (ECG) performed at Screening., 10.
Subjects must be able and willing to provide written informed consent and
comply with the requirements of this study protocol., 11. Subjects must be able
and willing to self-administer s.c. injections or have a qualified person
available to administer s.c. injections.

1. Subject has been previously treated with disease modifying antirheumatic
drugs (DMARDs) for rheumatic diseases., 2. Current active inflammatory joint
disease other than RA., 3. Subjects has had a dose of prednisone (or
equivalent) >7.5 mg/day or has had a dose change within the preceding 4 weeks.,
4. Subject has been treated with intra-articular or parenteral administration
of corticosteroids in the preceding 4 weeks. Inhaled corticosteroids for
stable medical conditions are allowed., 5. Subject has undergone joint surgery
within the preceding two months (at joints to be assessed within the study).,
6. Subject has chronic arthritis diagnosed before age 17 years., 7. Subject has
a history of an allergic reaction or significant sensitivity to constituents of
study drugs., 8. Subject has been treated with any investigational drug within
one month prior to screening visit., 9. Active infection of any kind (excluding
fungal infections of nail beds), or any major episode of infection requiring
hospitalization within 4 weeks of screening., 10. Subject has a poorly
controlled medical condition, such as uncontrolled diabetes, unstable heart
disease, congestive heart failure, recent cerebrovascular accidents and any
other condition which, in the opinion of the investigator, would put the
subject at risk by participation in the study., 11. Subject has a history of
clinically significant hematologic (e.g., severe anemia, leukopenia,
thrombocytopenia), renal or liver disease (e.g., fibrosis, cirrhosis,
hepatitis)., 12. Subject has history of neurologic symptoms suggestive of
central nervous system (CNS) demyelinating disease and/or diagnosis of central
demyelinating disease., 13. Subject has history of cancer or
lymphoproliferative disease. Allowable exceptions:
a. Successfully treated cutaneous squamous cell or basal cell carcinoma
b. Localized carcinoma in situ of the cervix
c. Curatively treated malignancy (treatment terminated) > 5 years prior to
screening, 14. Subject has a history of listeriosis, histoplasmosis, untreated
TB, persistent chronic infections, or recent active infections requiring
hospitalization or treatment with intravenous (iv) anti-infectives within 30
days or oral anti-infectives within 14 days prior to the BL visit., 15.
Subjects will be evaluated for latent TB infection with a PPD or QuantiFERON
test and X-ray. Subjects with evidence for latent TB will not be enrolled but
first assessed according to local guidelines., 16. Subject is known to have
immune deficiency, history of Human Immunodeficiency Virus (HIV) or is
otherwise severely immunocompromised., 17. Female subject who is pregnant or
breast-feeding or considering becoming pregnant during the study or within 150
days after the last dose of study medication., 18. Subject has a history of
clinically significant drug or alcohol usage in the last year., 19. Subject has
a chronic widespread pain syndrome., 20. Subject is considered by the
investigator, for any reason, to be an unsuitable candidate for the study., 21.
Subject is unwilling to comply with the study protocol., 22. Screening clinical
laboratory analyses show any of the following abnormal laboratory results:
a. Aspartate transaminase (AST) or alanine transaminase (ALT) > 1.75 times
upper limit of normal (ULN).
b. Positive serum human chorionic gonadotropin (hCG).
c. Positive tests for hepatitis B surface antigen (HBsAg) or hepatitis C
serology indicative of current infection.
d. Creatinine levels > 2x the ULN. If creatinine 1-2 times ULN, check GFR.
e. Hemoglobin < 90 g/L.
f. Absolute neutrophil count (ANC) < 1.5 x 10^3/microL.
g. Serum total bilirubin >= 1.5 mg/dL (>= 26 micromol/L).