A Study of Tocilizumab in Comparison to Etanercept in Participants With Rheumatoid Arthritis and Cardiovascular Disease Risk Factors

Inclusion Criteria:

• Male and female participants, greater than or equal to (>/=) 50 years of age
• Participants with moderate to severe rheumatoid arthritis of >/=6 months duration
• Inadequate response to at least one non-biologic DMARD
• Positive for Rheumatoid Factor (RF) and/or anti-cyclic citrullinated peptide (CCP) antibodies at screening
• Have a C-Reactive Protein (CRP) greater than (>) 0.3 milligrams per deciliter (mg/dL) at screening or at the baseline visit
• Swollen joint count (SJC) and Tender joint count (TJC) >/= 8 during screening or at the baseline visit
• History of Coronary Heart Disease (CHD) or presence of one or more additional CHD risk factors, including current cigarette smoking, hypertension, low High Density Lipoprotein (HDL) cholesterol, family history of premature CHD, diabetes, presence of extra-articular disease associated with rheumatoid arthritis
• At the time of randomization, will have discontinued infliximab, adalimumab, golimumab, or certolizumab for >/= 4 weeks
• Females of childbearing potential must have a negative pregnancy test within 28 days of randomization and must be ready to use reliable contraceptive methods

Exclusion Criteria:

• Major surgery (including joint surgery or coronary revascularization) within 8 weeks prior to screening or planned major surgery within 1 year of study start
• Rheumatic autoimmune disease other than rheumatoid arthritis
• History of, or current, inflammatory joint disease other than rheumatoid arthritis
• Current or recent (within past 3 months) evidence of serious uncontrolled concomitant cardiovascular or cerebrovascular disease (Myocardial infarction, revascularization, stroke, transient ischemic attack, or acute coronary syndrome)
• Current or previous (within the past 2 years) evidence of serious uncontrolled concomitant pulmonary (including obstructive pulmonary disease), renal, hepatic, endocrine (including uncontrolled diabetes mellitus) or gastrointestinal disease
• Uncontrolled disease states, such as asthma or inflammatory bowel disease where flares are commonly treated with oral or parenteral corticosteroids
• Pre-existing central nervous system demyelinating or seizure disorders
• History of diverticulitis, diverticulosis requiring treatment or other lower gastrointestinal tract conditions that might predispose to perforations
• Current liver disease as determined by the investigator; a history of asymptomatic elevations in liver function tests (LFTs) is not considered an exclusion
• Active current infection or history of recurrent bacterial, viral, fungal, mycobacterial or other infections, including but not limited to tuberculosis and atypical mycobacterial disease, hepatitis B and C, and herpes zoster, but excluding fungal infections of nail beds
• Any major episode of infection requiring hospitalization or treatment with intravenous (IV) antibiotics within four weeks of screening or oral antibiotics within two weeks prior to screening visit
• Active tuberculosis (TB) requiring treatment within 3 years prior to baseline
• Latent TB diagnosed during screening that has not been appropriately treated
• Primary or secondary immunodeficiency (history of or currently active)
• Moderate to severe heart failure
• Evidence of active malignant disease, malignancies diagnosed within the previous 10 years (including hematologic malignancies and solid tumors, except basal cell carcinoma of the skin that has been excised and cured), or breast cancer diagnosed within the previous 20 years
• Breast feeding mothers
• History of alcohol, drug or chemical abuse within the six months prior to screening
• Participants with lack of peripheral venous access
• Participants with a history of allergic reactions to latex
• Previous treatment with non-TNF-inhibitor biologic therapy
• Treatment with any investigational agent within four weeks of screening visit
• Treatment with any cell depleting therapies within 1 year of baseline
• Treatment with IV gamma globulin, plasmapheresis or Prosorba? column within six months of baseline visit
• Immunization with a live/attenuated vaccine within four weeks prior to baseline visit
• Any previous treatment with alkylating agents, such as cyclophosphamide or chlorambucil, or with total lymphoid irradiation