Strategic reduction of joint destruction in rheumatoid arthritis

INTERVENTION: TNF‐inhibitors plus MTX TNF‐inhibitors are used for 54 weeks and exchange among them is approved MTX MTX is used for 54 weeks and addition of the other DMARD is approved CONDITION: Rheumatoid arthritis PRIMARY OUTCOME: Comparison of reduction of joint destruction between TNF‐inhibitors and MTX alone. SECONDARY OUTCOME: (1) new bone erosion; (2) DAS28; (3) EULAR‐improvement criteria; (4) HAQ INCLUSION CRITERIA: Patients who meet all of the following criteria will be enrolled in this study: 1) Patients with RA diagnosed according to the criteria of the American College of Rheumatology (ACR) (1987) 2) Patients who develop develop moderate or high activity, despite NSAID and/or DMARD therapy 3) Patients who agreed to practice an appropriate contraception during the study period