Impact of Rituximab on MRI Evidence of Disease Activity in Patients With Moderate to Severe Rheumatoid Arthritis

Inclusion Criteria * Able and willing to give written informed consent * Age 18-80 years * Must have active rheumatoid arthritis for at least 12 weeks, but no more than 5 years. * Must be receiving treatment on an outpatient basis * Must have \> 8 tender and swollen joints * Must have negative serum pregnancy test * Must have an inadequate response to MTX * Must have elevated serology parameters * Must have Positive RF or anti-CCP antibody, or radiographic evidence of at least one joint with definite erosion attributable to RA. * Stable use of Corticosteroids is permitted * Stable use of NSAIDs is permitted Exclusion Criteria: * History of or current inflammatory joint disease * Functional class IV * Any surgical procedure within 12 weeks * Lack of peripheral venous access. * Pregnancy or breast feeding. * Significant cardiac or pulmonary disease. * Evidence of significant uncontrolled concomitant disease * Positive HIV * Known active infection of any kind * History of deep space/tissue infection * History of recurrent significant infection * Concomitant malignancies or previous malignancies * Any neurological, vascular or systemic disorder * History of drug, alcohol, or chemical abuse * Inability to comply with study and follow-up procedures * History of a severe allergic or anaphylactic reaction to a biologic agent * Previous treatment with more than one biologic agent for RA. Patients must not have received a biologic agent within 2 months prior to the Baseline visit, except for etanercept, abatacept and anakinra for which a one month washout prior to Baseline visit is acceptable * Previous treatment with an anti-alpha 4 integrin antibody or co-stimulation modulator. * Previous treatment with any cell depleting therapies. * Treatment with any investigational agent within 28 days * Receipt of a live/attenuated vaccine within 28 days * Ongoing use of high dose steroids (\>10mg/day) * Inra-articular or parental glucocorticoids within 4 weeks prior to baseline. * Intolerance or contraindications to i.v. glucocorticoids.