To compare the effectiveness of two treatment strategies in early rheumatoid arthritis (ERA), namely the delayed usual care and early intensive care, in Hong Kong.

• The delayed usual care reflects the usual treatment practice in Hong Kong
• The early intensive care includes tight monitoring and immediate adjustment of therapy

This study is a 1-year non-randomized clinical trial. Two groups of patients (delayed usual care and early intensive care) with diagnosis of rheumatoid arthritis (RA) and with symptoms onset of less than 2 years and disease modifying anti-rheumatic drugs (DMARDs) naive will be recruited. Remission is reached if patients fulfill the Boolean criteria.

Inclusion Criteria:

For usual care group:

• patients with at least 1 tender and swollen joint
• duration of symptoms less than 2 years
• no previous use of DMARDs

For intensive care group:

• patients with at least 1 tender and swollen joint
• duration of symptoms less than 2 years
• no previous use of DMARDs
• patients who fulfill the 2010 ACR/EULAR classification criteria for RA

Exclusion Criteria:

• patients with renal impairment (on dialysis or estimated Glomerular Filtration Rate (eGFR) <30 mL/min/1.73m^2)