18 to 80 years old
Biologic therapy (etanercept (Enbrel)as prescribed by MD
Assessment of circadian rhythm by wearing a wrist actigraph/keeping diary for 7 days prior to biologic therapy and 30 days afterwards
Two study visits (joint examination and a fasting blood draw to measure markers of inflammation)
6/28 tender and 6/28 swollen joints (e.g. active rheumatoid arthritis)
CRP ≥ 1.5mg/L
Insufficient response or intolerance to ≥1 disease modifying anti-rheumatic drug (DMARD) which must include methotrexate or hydroxychloroquine, or sulfasalazine or leflunomide and at stable dose for 4 weeks
If taking Glucocorticoids, stable dose from 0-10mg a day for 2 weeks, and remain stable for the 4 week study
Appropriate to start on a biologic agent for RA, as determined by patient's physician.
Prior use of a biologic agent for 4 weeks prior to the study
Evidence of positive tuberculosis (TB) test, purified protein derivative (PPD) or Quantiferon or prophylactic treatment instituted 4 weeks before study, or hepatitis B core antibody
No medical condition that would prevent completion of the study
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