Adalimumab in rheumatoid arthritis. An investigation of changes in disease activity and course of joint destruction by use of 3 Tesla Whole-Body MRI, dedicated 3 Tesla MRI and CT of the hand, and soluble biomarkers. Furthermore to compare ultrasound examination with wholebody MRI etc.

Inclusion Criteria:

• Age > 18 years old and < 85 years old
• RA in accordance with American College of Rheumatology 1987 criteria
• Moderate or highly active RA defined as DAS28 > 3,2 (CRP based)
• Clinical indication for TNF-α inhibitor treatment by the treating physician
• No contraindications for TNF-α inhibitor treatment
• No contraindications for MRI
• Serum creatinine in normal range
• Sufficient contraception for fertile women
• Capable of giving informed consent
• Capable of complying with the examination program of the protocol

Exclusion Criteria:

• Other DMARDs than MTX from less than 4 weeks before inclusion and throughout the study period
• Cyclophosphamide, Chlorambucil or other alkylating agents from less than 4 weeks before inclusion and throughout the study period
• Intramuscular or intravenous injection of glucocorticoid from less than 4 weeks before inclusion and throughout the study period
• Pregnancy wish, pregnancy or breast-feeding
• Contraindications for TNF-α inhibitor treatment
• Contraindications for MRI
• Known recent drug or alcohol abuse
• Failure to provide written consent
• Incapable of complying with the examination program for physical or mental reasons

Patients with rheumatoid arthritis according to the ACR criteria (1987) with high disease activity starting TNF-alpha inhibitor