An Evaluation of the Optimal Dose of Tofacitinib Needed to Achieve Low Disease Activity (LDA) or Clinical Remission in Patients With Active Rheumatoid Arthritis (RA) as Measured From a Clinical and Structural Perspective

Exclusion Criteria

• •1. Patients who have a history of any inflammatory disease which would be interfere with outcome measurement
• •2. Patients who in the Investigator's opinion have a medical condition in which participation in this trial is contraindicated
• •3. Patients who have received intramuscular, intravenous, or intraarticular (IM/IV/IA) corticosteroids 28 days prior to baseline.
• •4. Patients who have active TB or a history of active TB (positive PPD skin test \>5mm and a positive chest x-Ray) or patients who have come in close contact with an individual with active TB.
• •5. Patients with a history of acute or chronic viral hepatitis B or C or those who test positive at screening.
• •6. Patients with a known human immunodeficiency virus (HIV) infection.
• •7. Concurrent malignancy or a history of malignancy other than a non-metastatic basal cell or squamous cell cancer of the skin or cervical carcinoma in situ.
• •8. Patients who have a metal device affected by MRI (e.g. any type of electronic, mechanical or magnetic implant; cardiac pacemaker; aneurysm clip(s); implanted cardioverter defibrillator; or cochlear implant)
• •9. Patients who have potential ferromagnetic foreign body (metal slivers metal shavings, other metal objects) for which they have sought medical attention
• •10. Patients at a high risk of infection in the Investigator's opinion or have had recurrent infections requiring hospitalization or parenteral antimicrobial therapy within the past 6 months.
• •11. Patients with an adverse reaction to tofacitinib
• •12. Patients with any other condition (e.g., clinically significant laboratory values) which in the Investigator's judgment would make the patient unsuitable for inclusion in this study
• •13. Patients who have received prohibited medications:
• •the following approved biological therapy for RA: etanercept, adalimumab, anakinra, abatacept, tocilizumab within 28 days of baseline
• •rituximab within 9 months of baseline
• •infliximab within 56 days of baseline
• •DMARDs other than methotrexate within 28 days of baseline
• •any experimental biologic agent within three months or 5 half-lives prior to baseline
• •exposure to JAK inhibitor 14. Female patients who are breast-feeding, pregnant, or plan to become pregnant during the trial or within twelve weeks following last dose of study drug