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Rheumatoid Arthritis Trial Screening
If you are interested in participating, please complete the following survey. It has 8 questions, and most are yes/no questions.
1.
Do you have a diagnosis of adult-onset rheumatoid arthritis (RA)?
Yes
No
2.
Have you tried an anti-rheumatic drug that did not work or that you were intolerant to?
Yes
No
I'm not sure
3.
Do you have at least one of the following:
Documented evidence of a venous thromboembolism (blood clot in a vein)
Age greater than or equal to 60 years
BMI greater than or equal to 30
Age between 50 and 60 years AND BMI between 25 and 30
Yes
No
I'm not sure
4.
Do you have any known intolerance to TNF inhibitors? Examples listed below.
Infliximab, adalimumab, etanercept, golimumab, or certrolizumab.
Yes
No
I'm not sure
5.
Have you been treated with one of these drugs in the last four weeks?
Abatacept, adalimumab, anakinra, certolizumab pegol, etanercept, golimumab, infliximab, sarilumab, tocilizumab, rituximab, or ustekinumab
Yes
No
I'm not sure
6.
Have you been treated with one of these drugs?
Baricitinib, tofacitinub, upadacitinib
Yes
No
I'm not sure
7.
Are you currently taking probenecid, rifampicin, or novobiocin?
Yes
No
I'm not sure
8.
Please, leave your name and phone number for us to contact you should you qualify for this trial.
Name:
Phone #: