This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The purpose of this research trial is to determine if it is better to treat all patients with aggressive rheumatoid arthritis (RA) with multiple disease modifying drugs (DMARDs), medicines that treat the root of RA and work to prevent damage to joints, not just the symptoms of pain and swelling, or to save the use of multiple DMARDs for those who do not respond well tomethotrexate. Also, the study will evaluate whether etanercept or the combination of sulfasalazine and hydroxchloroquine is is a preferred treatment when used in combination with methotrexate in RA not fully responsive to methotrexate alo
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