Comparing two newer arthritis treatments when first-line therapy isn't working

This trial is testing whether two different classes of newer rheumatoid arthritis medications work equally well when your current treatment isn't controlling your disease. You would be randomly assigned to try either a targeted synthetic DMARD (such as tofacitinib, baricitinib, or upadacitinib) or a non-TNFi biologic (such as rituximab, abatacept, tocilizumab, or sarilumab). The study wants to understand which medication helps patients feel better, function more normally, and improve their quality of life.

Right now, doctors don't have clear evidence showing which of these two newer treatment types works better when your first arthritis medication stops working well. Most patients receive a second similar medication to their first one, but guidelines now recommend trying one of these newer options instead—and this study will provide the real-world evidence needed to help you and your doctor make the best choice together.