Primary Objectives
1. To test the feasibility, in patients with active rheumatoid arthritis, of using an
'aggressive' treatment algorithm to bring a short term treatment objective (STO) within
the normal or an arbitrarily defined 'desirable' range.
2. To determine whether patients with active rheumatoid arthritis randomly allocated to a
particular STO show a reduced rate of Magnetic resonance imaging damage progression at
two years compared to those randomly allocated to usual care.
Secondary Objectives
1. To establish the relationship between achieving a given STO or combination of STOs and
damage progression.
2. To identify the characteristics of responders and non-responders with respect to STO
achievement and predictors of greater and lesser degrees of damage progression.