Switching Anti-TNF-Alpha Agents in Rheumatoid Arthritis (RA)

Inclusion Criteria:

   - Diagnosis of Rheumatoid Arthritis

   - Current treatment with either etanercept or adalimumab for at least 12 weeks prior to
   randomization

   - Disease Activity Score (DAS) C-reactive Protein (CRP) 28 ≥ 4.4

   - Treatment with concomitant Disease-Modifying Anti-Rheumatic Drugs (DMARDs) is
   permitted but not required as described below:

      1. Methotrexate - maximum dose of 25 mg per os (PO), intra-muscular (IM), or SQ
      weekly.

      2. Leflunomide - maximum dose of 20 mg PO daily.

      3. Sulfasalazine - maximum dose of 1,500 mg PO twice daily.

      4. Hydroxychloroquine - maximum dose of 400 mg PO daily.

   - If taking DMARD(s), subjects must be on stable doses for at least 12 weeks prior to
   randomization.

   - If treated with prednisone (or equivalent corticosteroid), on a stable dose of <= 10
   mg/day for 28 days prior to randomization.

   - Agree to use appropriate form of contraception. More information on this criterion can
   be found in the protocol.

Exclusion Criteria:

   - Diagnosis of another autoimmune disease likely to require immunosuppression. More
   information on this criterion can be found in the protocol.

   - Failing treatment with etanercept if previously treated with adalimumab

   - Failing treatment with adalimumab if previously treated with etanercept

   - Intraarticular injection within 4 weeks prior to randomization

   - Concomitant use of DMARDs other than those described in Inclusion Criteria within 12
   weeks of randomization.

   - Concurrent use of any biologic agent other than etanercept or adalimumab

   - Concomitant immunosuppressive therapy other than the Disease-Modifying Anti-Rheumatic
   Drugs (DMARDs), non-steroidal anti-inflammatory drugs (NSAIDs), or corticosteroids
   specified in the protocol

   - Presence of open leg ulcers

   - Chronic or persistent infection that may be worsened by immunosuppressive treatment.
   More information on this criterion can be found in the protocol.

   - Active infection or severe infections requiring hospitalization or treatment with
   intravenous antibiotics, antivirals, or antifungals within 30 days prior to
   randomization

   - History of positive Purified Protein Derivative (PPD) or chest x-ray findings
   indicative of prior tuberculosis infection

   - Any medical condition or treatment that, in the opinion of the investigator, would put
   the subject at risk by participation in the study

   - History of malignancy. More information on this criterion can be found in the
   protocol.

   - Certain abnormal laboratory values. More information on this criterion can be found in
   the protocol.

   - Investigational biological or chemical agents within 4 weeks prior to randomization.

   - History of drug or alcohol abuse within a year prior to randomization

   - Treatment with natalizumab, rituximab, or another B-cell depleting therapy within a
   year prior to randomization

   - Treatment with infliximab, abatacept, tocilizumab, golimumab, or certolizumab pegol
   within 12 weeks prior to randomization.

   - Known allergy or hypersensitivity to study products

   - Any psychiatric disorder that prevents the participant from providing informed consent

   - Inability to follow protocol instructions

   - Pregnant or breastfeeding