| E.1 Medical condition or disease under investigation | 
| E.1.1 | Medical condition(s) being investigated  | 
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| E.1.1.1 | Medical condition in easily understood language  | 
| Rheumatoid Arthritis is a chronic inflammatory disease causing pain and swelling in the joints. The cause of the disease is unknown. In addition, the disease can involve other tissues of the body. | 
 
 
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| E.1.1.2 | Therapeutic area  | Diseases [C] - Musculoskeletal Diseases [C05] | 
| MedDRA Classification | 
| E.1.2 Medical condition or disease under investigation | 
| E.1.2 | Version  | 18.1 | 
 
| E.1.2 | Level  | PT | 
 
| E.1.2 | Classification code  | 10039073 | 
 
| E.1.2 | Term  | Rheumatoid arthritis | 
 
| E.1.2 | System Organ Class  | 10028395 - Musculoskeletal and connective tissue disorders | 
 
 
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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 objective of this study is to compare the treatment efficacy between adalimumab-Pfizer and adalimumab-EU in subjects with moderately to severely active RA who are treated with adalimumab in combination with methotrexate. | 
 
 
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| E.2.2 | Secondary objectives of the trial  | 
- To evaluate the overall safety and tolerability of adalimumab-Pfizer and adalimumab-EU.
 - To evaluate the immunogenicity of adalimumab-Pfizer and adalimumab-EU.
 - To evaluate multiple composite and individual parameters of clinical response to adalimumab-Pfizer and adalimumab-EU.
 - To evaluate the overall safety, tolerability and immunogenicity of adalimumab-Pfizer after treatment transition from adalimumab-EU to adalimumab-Pfizer.
 - To evaluate the population pharmacokinetics (PK) of adalimumab-Pfizer and adalimumab-EU.
 - To evaluate the pharmacodynamic (PD) response to adalimumab-Pfizer and adalimumab-EU. | 
 
 
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| E.2.3 | Trial contains a sub-study  |  No  | 
| E.3 | Principal inclusion criteria  | 
- Diagnosis of rheumatoid arthritis based on 2010 ACR/EULAR criteria for at least 4 months.
 - At least 6 tender (of 68 assessed) and 6 swollen (of 66 assessed) joints at screening and baseline.
 - Hs-CRP equal or greater than 8 mg/L.
 - Must have received methotrexate for at least 12 weeks and been on a stable dose for at least 4 weeks prior to the first study dose.
 
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| E.4 | Principal exclusion criteria | 
- Evidence of untreated or inadequately treated latent or active TB.
 - Evidence of uncontrolled, clinically significant diseases, including moderate or severe heart failure (NYHA Class III/IV) or malignancy in the previous 5 years.
 - History of infection requiring hospitalization or parenteral antimicrobial therapy within 6 months prior to first dose of study drug.
 - May have received no more than 2 doses of one biologic therapy (other than adalimumab or lymphocyte depleting therapy).
 - Any second DMARD (Disease modifying anti-rheumatic drug) must be washed out prior to the first study dose. | 
 
 
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| E.5 End points | 
| E.5.1 | Primary end point(s) | 
| Number of Participants With an American College of Rheumatology 20% (ACR20) Response | 
 
 
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| E.5.1.1 | Timepoint(s) of evaluation of this end point | 
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| E.5.2 | Secondary end point(s) | 
- Number of Participants With an American College of Rheumatology 20% (ACR20) Response
 - Number of Participants Achieving American College of Rheumatology 50% (ACR50) Response
 - Number of Participants Achieving American College of Rheumatology 70% (ACR70) Response
 - Disease Activity Score Based on 28-joints Count (DAS28)-4(CRP)
 - DAS Remission (≤2.6)
 - EULAR Response
 - Change from baseline in individual components of ACR response
 - Incidence and titers of anti-drug antibodies (ADA) and neutralizing antibodies (Nab)
 - Serum drug concentration
 - Type, incidence, severity, timing, seriousness and relatedness of  events (AEs) and laboratory abnormalities. | 
 
 
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| E.5.2.1 | Timepoint(s) of evaluation of this end point | 
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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 |  No  | 
| E.6.12 | Pharmacoeconomic |  No  | 
| E.6.13 | Others |  Yes  | 
| E.6.13.1 | Other scope of the trial description | 
Immunogenicity,
 biosimilar | 
 
 
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| 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) |  Yes  | 
| E.8.2.2 | Placebo  |  No  | 
| E.8.2.3 | Other |  No  | 
| E.8.2.4 | Number of treatment arms in the trial | 2 | 
| 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 | 2 | 
| E.8.5 | The trial involves multiple Member States |  Yes  | 
| E.8.5.1 | Number of sites anticipated in the EEA | 115 | 
| 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 |  No  | 
| 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 | 
| Argentina | 
 
| Australia | 
 
| Brazil | 
 
| Bulgaria | 
 
| Canada | 
 
| Colombia | 
 
| Croatia | 
 
| Czech Republic | 
 
| Estonia | 
 
| France | 
 
| Georgia | 
 
| Germany | 
 
| Hungary | 
 
| Japan | 
 
| Korea, Republic of | 
 
| Lithuania | 
 
| Mexico | 
 
| New Zealand | 
 
| Peru | 
 
| Poland | 
 
| Russian Federation | 
 
| Serbia | 
 
| South Africa | 
 
| Spain | 
 
| Taiwan | 
 
| Ukraine | 
 
| United Kingdom | 
 
 
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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 | 1 | 
| E.8.9.1 | In the Member State concerned months | 6 | 
| E.8.9.1 | In the Member State concerned days | 0 | 
| E.8.9.2 | In all countries concerned by the trial years | 2 | 
| E.8.9.2 | In all countries concerned by the trial months | 10 | 
| E.8.9.2 | In all countries concerned by the trial days | 0 |