Inclusion Criteria:  Diagnosis of RA based on ACR/EULAR 2020 Classification Criteria Moderate-to-high disease activity according to clinical disease activity indices Referred to the biologics clinic (The Ottawa Hospital Arthritis Centre) by their primary rheumatologist who practices within the division following decision to escalate to, or switch between, advanced therapy.  Exclusion Criteria:  Any contraindication to initiation of either Upadacitinib or Adalimumab Unable to come to follow-up at 1, 3, and 6 months Current or planned (within 6 months) pregnancy or breastfeeding Inability to give informed consent Inability to communicate verbal or written responses to pain questionnaires Intraarticular steroid injections if done within 30 days of first visit Initiation of study intervention prior to baseline assessment Previous use of either study drug