The Chinese University of Hong Kong Early Arthritis Study

Inclusion Criteria: * Men and women, 18 years of age or older * Clinical diagnosis of RA with a duration not more than 24 months (Fulfilled the 1987 American College of Rheumatology (ACR) criteria for RA) * Patients at risk of developing persistent or erosive arthritis * DAS 28 ≥ 3.2 * Prednisolone \< 10mg/day and started at least 4 weeks before baseline * Either has ESR ≥ 28, CRP ≥ 10, presence of rheumatoid factor or anti-CCP, present of HLADRB\*0401 or DRB1\*0404, and radiographic erosions * Informed consent Exclusion Criteria: * Little or no ability for self-care * Previous treatment with DMARDs other than antimalarials * Concomitant treatment with an experimental drug * Malignancy within the last 5 years * Bone marrow hypoplasia * Clinically significant renal disease ( serum creatinine level ≥ 150µmol/L) or estimated creatinine clearance \> 75ml/min, alanine aminotransferase (ALT) exceeds the upper limit of normal * History of any clinically significant adverse reaction to murine or chimeric proteins * History of TB in the last 5 years * Known to have hepatitis B, or hepatitis C * Had an opportunistic infection (e.g. herpes zoster, cytomegalovirus, Pneumocystis carinii, aspergillosis, histoplasmosis, or mycobacteria other than TB) within 6 months before screening * History or ongoing chronic or recurrent disease; renal infection, chest infection, urinary tract infection, ulcer or skin wound * History of infected joint prosthesis and use of antibiotics for the joint * Received intravenous antibiotics within 30 days or oral antibiotics within 14 days for screening * History of known demyelinating diseases (multiple sclerosis or optic neuritis) * Current signs or symptoms of severe diseases (renal, hepatic, hematologic, endocrine, pulmonary, cardiac, neurologic, etc) * History or concurrent CHF * History of lymphoproliferative disease, splenomegaly * Female of childbearing potential, unwilling to use adequate contraception during the study * Current or recent ( within the past 3 months) pregnancy and cancer * Active smoker, alcohol or drug abuse