| E.1 Medical condition or disease under investigation | 
| E.1.1 | Medical condition(s) being investigated  | 
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| MedDRA Classification | 
| E.1.2 Medical condition or disease under investigation | 
| E.1.2 | Version  | 12.1 | 
 
| E.1.2 | Level  | LLT | 
 
| E.1.2 | Classification code  | 10039073 | 
 
| E.1.2 | Term  | Rheumatoid arthritis | 
 
 
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| E.1.3 | Condition being studied is a rare disease  |  No  | 
| E.2 Objective of the trial | 
| E.2.1 | Main objective of the trial  | 
The primary objectives of this study are to demonstrate, in patients on background MTX therapy, the superiority of 120 mg LY2127399 every 4 weeks (Q4W) (LY A) or 90 mg LY2127399 every 2 weeks (Q2W) (LY B), each after a loading dose, compared to placebo as follows:   
  American College of Rheumatology 20% response rates (ACR20) at Week 24  Structural progression as measured by van der Heijde modified Total Sharp Score (mTSS) at Week 52  Health Assessment Questionnaire-Disability Index (HAQ-DI) scores at Week 24. 
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| E.2.2 | Secondary objectives of the trial  | 
The secondary objectives of the study are as follows: •  To demonstrate, in patients on background MTX therapy, the superiority of LY A or LY B compared to placebo over 52 weeks • To evaluate structure (X-rays)   • To evaluate the safety and tolerability of LY A or LY B compared to placebo. • To characterize the time course of change in absolute B cell counts, B cell subsets, and changes in serum Ig levels to treatment with LY2127399 versus placebo over 52 weeks. • To characterize the population PK of LY2127399 and explore PK/ PD relationships with efficacy, safety and biomarker endpoints. • To assess the potential development of anti LY2127399 antibodies and the impact on patient safety, efficacy, and PK of LY2127399. Additional exploratory measures will be studied, including: • To explore biomarkers that may be contained in serum, plasma, messenger ribonucleic acid (mRNA), and deoxyribonucleic acid (DNA) samples. | 
 
 
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| E.2.3 | Trial contains a sub-study  |  No  | 
| E.3 | Principal inclusion criteria  | 
• Male and female patients aged ≥18 years of age with a diagnosis of moderately to severely active adult onset RA  • Diagnosis of Rheumatoid Arthritis (RA) of more than 6 months and less than 15 years  • Regular use of methotrexate (MTX) in the past 12 weeks, with the dose being stable during the past 8 weeks  • At least 8 tender and swollen joints  • At least one erosion of a hand or foot joint observed on an X-ray  • An abnormally high C-reactive protein (CRP) level or erythrocyte sedimentation rate (ESR)  • Positive for Rheumatoid Factor (RF) or Anti-cyclic citrullinated peptide (CCP) antibody  • Woman must not be pregnant, breastfeeding, or become pregnant during the study  
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| E.4 | Principal exclusion criteria | 
• Use of unstable doses of non-steroidal inflammatory drugs (NSAIDS) in the past 6 weeks  • Steroid injection or intravenous (iv) infusion in the last 6 weeks  • Use of more than 10 mg/day of oral steroids in the last 6 weeks  • History of an inadequate response to a biologic disease-modifying anti-rheumatic drug (DMARD)  • History of a serious reaction to other biological DMARDs  • History of the use of rituximab or other B cell therapy  • Use of DMARDS other than MTX, hydroxychloroquine, or sulfasalazine within the last 8 weeks  • Use of leflunomide within the last 12 weeks (unless cholestyramine was used to speed up the elimination of leflunomide)  • Surgery on a joint or other major surgery less than 2 months ago, or plans to have joint surgery or major surgery during the study  • Active fibromyalgia, juvenile chronic arthritis, spondyloarthropathy, Crohn's disease, ulcerative colitis, psoriatic arthritis, or other systemic inflammatory condition except RA  • Cervical cancer or squamous skin cancer within the past 3 years, or other cancer within the past 5 years  • Received a live vaccine received within the past 12 weeks (for example, vaccines for measles, mumps, rubella, and chicken pox, and nasal-spray flu vaccines)  • Hepatitis or HIV  • A serious bacterial infection (for example, pneumonia or cellulitis) within 3 months or a serious bone or joint infection within 6 months  • Symptoms of herpes zoster or herpes simplex within the last month  • Active or latent tuberculosis (TB)  • Current symptoms of a serious disorder or illness  • Use of an investigational drug within the last month  
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| E.5 End points | 
| E.5.1 | Primary end point(s) | 
• Percentage of patients with American College of Rheumatology 20% response (ACR20) at Week 24 • Change from baseline to Week 52 in van der Heijde modified Total Sharp Score (mTSS)  • Change from baseline to Week 24 in Health Assessment Questionnaire-Disability Index (HAQ-DI)  • Percentage of patients with American College of Rheumatology 50% (ACR50) and 70% (ACR70) response • Change from baseline in Disease Activity Score C-Reactive Protein (DAS28-CRP) • Percentage of patients with DAS28-Based European League Against Rheumatism (EULAR) response • Change from baseline in Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) domain scores and summary scores • Change from baseline in Brief Fatigue Inventory (BFI) individual items and impact score • Change from baseline in duration of morning stiffness (minutes) • Percentage of patients with Major Clinical Response (MCR) during 52 weeks • Percentage of patients with change from baseline in mTSS less than or equal to 0 • Change from baseline in B cell subset counts • Population Pharmacokinetics (PK) • Percentage of patients developing anti-LY2127399 antibodies • Change from baseline in Brief Pain Inventory Short Form (BPI-sf) individual items and interference scores • Percentage of patients with structural inhibition at Week 52 • Change from baseline in mTSS  • Change from baseline in serum immunoglobulin (Ig) levels • Change from baseline in joint space narrowing score and bone erosions score (components of mTSS)  • Mean percent improvement in ACR N • Change from baseline in Tender Joint Count (68 joint count) • Change from baseline in Swollen Joint Count (66 joint count) • Change from baseline in Patient's Assessment of Pain (VAS) • Change from baseline in Patient's Global Assessment of Disease Activity (VAS) • Change from baseline in Physician's Global Assessment of Disease Activity (VAS) • Change from baseline to Week 52 in HAQ-DI  • Change from baseline in absolute B cell counts • Percentage of patients with ACR20 at Week 52 • Time to ACR20 response | 
 
 
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| E.6 and E.7 Scope of the trial | 
| E.6 | Scope of the trial | 
| E.6.1 | Diagnosis |  No  | 
| E.6.2 | Prophylaxis |  No  | 
| E.6.3 | Therapy |  No  | 
| E.6.4 | Safety |  Yes  | 
| E.6.5 | Efficacy |  Yes  | 
| E.6.6 | Pharmacokinetic |  Yes  | 
| E.6.7 | Pharmacodynamic |  Yes  | 
| E.6.8 | Bioequivalence |  No  | 
| E.6.9 | Dose response |  No  | 
| E.6.10 | Pharmacogenetic |  No  | 
| E.6.11 | Pharmacogenomic |  Yes  | 
| E.6.12 | Pharmacoeconomic |  No  | 
| E.6.13 | Others |  No  | 
| E.7 | Trial type and phase | 
| E.7.1 | Human pharmacology (Phase I) |  No  | 
| E.7.1.1 | First administration to humans |  No  | 
| E.7.1.2 | Bioequivalence study |  No  | 
| E.7.1.3 | Other |  No  | 
| E.7.1.3.1 | Other trial type description |  | 
| E.7.2 | Therapeutic exploratory (Phase II) |  No  | 
| E.7.3 | Therapeutic confirmatory (Phase III) |  Yes  | 
| E.7.4 | Therapeutic use (Phase IV) |  No  | 
| E.8 Design of the trial | 
| E.8.1 | Controlled |  Yes  | 
| E.8.1.1 | Randomised |  Yes  | 
| E.8.1.2 | Open |  No  | 
| E.8.1.3 | Single blind |  No  | 
| E.8.1.4 | Double blind  |  Yes  | 
| E.8.1.5 | Parallel group |  Yes  | 
| E.8.1.6 | Cross over  |  No  | 
| E.8.1.7 | Other |  No  | 
| E.8.2 |  Comparator of controlled trial | 
| E.8.2.1 | Other medicinal product(s) |  No  | 
| E.8.2.2 | Placebo  |  Yes  | 
| E.8.2.3 | Other |  No  | 
| E.8.3 | 
                                The trial involves single site in the Member State concerned
                             |  No  | 
| E.8.4 |  The trial involves multiple sites in the Member State concerned  |  Yes  | 
| E.8.4.1 | Number of sites anticipated in Member State concerned | 13 | 
| E.8.5 | The trial involves multiple Member States |  Yes  | 
| E.8.5.1 | Number of sites anticipated in the EEA | 52 | 
| E.8.6 Trial involving sites outside the EEA | 
| E.8.6.1 | Trial being conducted both within and outside the EEA |  Yes  | 
| E.8.6.2 | Trial being conducted completely outside of the EEA |  Information not present in EudraCT  | 
| E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned | 
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| E.8.7 | Trial has a data monitoring committee |  Yes  | 
| E.8.8 | 
                        Definition of the end of the trial and justification where it is not the last
                        visit of the last subject undergoing the trial
                     | 
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| E.8.9 Initial estimate of the duration of the trial | 
| E.8.9.1 | In the Member State concerned years | 4 | 
| E.8.9.1 | In the Member State concerned months | 3 | 
| E.8.9.1 | In the Member State concerned days | 0 | 
| E.8.9.2 | In all countries concerned by the trial years | 4 | 
| E.8.9.2 | In all countries concerned by the trial months | 3 | 
| E.8.9.2 | In all countries concerned by the trial days | 0 |