The ArthritisPower Wearable Study

Rheumatoid arthritis patients being seen at one of the participating clinical sites in a U.S. network of community rheumatology practices who are starting treatment on adalimumab or upadacitinib will be enrolled into a 24-week study combining clinical data from physicians, self-reported patient outcomes from the ArthritisPower registry app, and activity and sleep data from a Fitbit wearable device.

The primary objective of this study is:

• Evaluate longitudinal associations between biometric sensor data (activity and sleep measures), physician-derived data (including clinical disease activity index (CDAI), Rheumatoid Factor (RF) lab results and other relevant biomarkers, current medications and disease duration), and patient-reported outcomes (PROs) (including PROMIS pain interference, physical function, fatigue, sleep disturbance, satisfaction with participation in discretionary social activities, and anxiety).

The secondary objectives of this study are as follows:

* Explore the reliability and predictive validity of biometric sensor data to classify changes in RA disease activity and associated symptoms, including PROs.
* To assess adherence and predictors of adherence with use of biometric sensor
* Assess/track changes in upadacitinib and adalimumab patients using combined physician, PRO and biosensor data.


Eligibility Criteria:
Inclusion Criteria:

* Age 19 and above who are adults (i.e., the age of majority where they reside)
* Diagnosis of RA by a physician (as indicated by survey screening questions)
* Currently being seen by a U.S. rheumatologist
* Starting on the day of enrollment (with no prior use ever) or soon-to-initiate (i.e. in the next 28 days) upadacitinib or adalimumab for RA
* Ability to walk without the use of assistive devices;
* Have access to a computer or smartphone to take health assessments and a survey;
* Already own a smartphone (iPhone or Android); iPhone 4S and later or Android 4.3 and later
* Are willing to join the ArthritisPower patient registry;
* Are willing to download the ArthritisPower app;
* Are willing to contribute daily and weekly ePROs for at least at 89 days, and health activity tracker data for at least 84 days (lead-in period minimum of 5 days plus main study period 84 days). Some participants may contribute data more than 89 days if there was a lag in receiving their medication and hence later medication start date;
* Are willing to wear the smartwatch while sleeping;
* Are willing to complete the 7-day run-in requirements (i.e. completing daily PRO assessments for at least 5 of 7 days);
* Have started their medication within 30 days of enrolling in the study (i.e. enrolling in ArthritisPower)
* Will not be out of internet access (wifi and/or mobile data) for 4 or more consecutive days during the study; and
* Willing to be contacted by e-mail/text message and/or phone by the study coordinator if participants fail to adhere to the study Protocol or for any study related assistance as required.
* Clinician must collect a CDAI (including the raw scores for the four components - patient global, physician global and tender and swollen joint count) on day of enrollment.
* CDAI must be \>10
* Must have rheumatoid and CCP antibody lab results available, or collect those labs (as part of standard of care during the enrollment visit) if not available