This clinical trial is focused on studying treatments for Rheumatoid Arthritis, a condition that causes pain and swelling in the joints. The study is comparing two different treatment approaches for patients who have not responded well to certain medications. One approach involves using either Methotrexate or Leflunomide combined with a targeted therapy, which is a treatment designed to specifically target certain parts of the immune system. The other approach uses a combination of Methotrexate or Leflunomide with Sulfasalazine and Hydroxychloroquine, which are medications that help reduce inflammation.
The purpose of the study is to find out if the targeted therapies are more effective than the combination of the three medications. The study will last for about 12 months, during which participants will receive one of the treatment combinations. The medications being studied include Rituximab, Tocilizumab, Infliximab, Golimumab, Certolizumab Pegol, Sarilumab, Etanercept, Abatacept, Filgotinib, Upadacitinib, Adalimumab, Tofacitinib, Baricitinib, and a placebo. These medications are administered either orally, through an injection, or as an infusion.
Throughout the study, participants will be monitored to assess the effectiveness of the treatments and any side effects. The goal is to achieve low disease activity, which means reducing the symptoms of Rheumatoid Arthritis to a manageable level. The study will also track the occurrence of any serious side effects and measure the levels of the medications in the blood. This information will help determine the best treatment strategy for patients with Rheumatoid Arthritis who have not had success with initial treatments.
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