Inclusion Criteria:
* Must pass communicable disease screen tests for HIV, syphilis, Hepatitis B and C Consistent with American Rheumatism Association-European League Against Rheumatism (ACR/EULAR) 2010 rheumatoid arthritis classification criteria
* Active Rheumatoid Arthritis, see RA functional status of class I-IV
* Patients must meet at least one of the following: \> 6 swollen joints and ≥ 6 involved joints (tenderness, swelling, deformity, pain on motion, or decreased motion) and morning stiffness ≥ 45 minutes based on 68 joint count.
* Patients must also meet at least one of the following: rheumatoid factor (RF) \> 15 IU/mL or \> 1:16, C-reactive protein (CRP) \> 2.0 mg/dL, Erythrocyte Sedimentation Rate (ESR) \> 30 mm/hour, and anti-cyclic citrullinated protein (Anti-CCP) \> 20 U/mL, TNFα \> 2.8 pg/mL.
* Patients must have failed anti-rheumatoid drug due to adverse event or inefficacy for at least 12 week and at least 4 weeks on stable dose of methotrexate ≤ 25 mg/week, or leflunomide ≤ 20 mg/day, or sulfasalazine ≤ 3 g/day, or steroids (Prednisone \<10 mg/day).
* For other medications, patients must be on the stable dose for at least 4 weeks prior to study entry in order to preclude changes to patient medication while participating on the study to ensure that a medication change could become a confounding factor in data interpretation.
* All patients must be clinically stable with no significant changes in health status a minimum of at least 4 weeks prior to randomization and confirming patient eligibility
Exclusion Criteria:
1. Current or prior to treatment
* Participation in another clinical study (with use of another Investigational Medical Product) within 3 months prior to study treatment start
* Evidence of immune suppression related to prior/current therapy
* \> 10% change in delivered monthly dose of anti-rheumatoid medications within 4 weeks prior to this stem cell infusion
* Use of a new or additional anti-rheumatoid medication within 6 weeks prior to this stem cell infusion
* Use of other stem cell therapy within 12 weeks prior to this stem cell therapy
* Unwillingness or inability to comply with study procedures
2. Concurrent Conditions
* Clinically active malignant disease
* Severe bladder or thrombotic disorder
* History of known pulmonary embolism or known secondary anti-phospholipid syndrome
* Known or suspected hypersensitivity to any components used to culture or store the AdMSCs, e.g. sulfur or sulfonamide
* Known or suspected antibodies to any components used to culture the AdMSCs, e.g. BSA and sulfur containing products (e.g., DMSO)
* Active infection at time of planned study treatment start
* Age related pathology likely to inhibit study participation or completion
* Major trauma or surgery within 14 days of study treatment start
* Mental condition rendering the subject (or the subject's legally acceptable representative\[s\]) unable to understand the nature, scope and possible consequences of the study
* Alcohol, drug, or medication abuse within one year before study treatment start
* Any condition that, in the Investigator's opinion, is likely to interfere with evaluation of the AdMSC therapy or satisfactory conduct of the study
* Irreversible severe end organ failure, such as heart failure/attack, stroke, liver and renal failure
* Heavy smokers, bed-bound patients, patients or family history with hypercoagulable status, such as protein C/protein S deficiency, factor V Leiden, prothrombin gene mutation, dysfibrinogenemia, etc.
3. Laboratory Parameters
* Hepatic impairment, defined as any of ALT, AST, LDH or bilirubin \> 2 x the upper limit of normal (ULN) range according to local laboratory standards
* Renal impairment, defined as serum creatinine \> 133 mmol/L (1.5 mg/dL)
* Positive virology/serology for human immunodeficiency virus (HIV), hepatitis B (HBsAg positive), hepatitis C and/or syphilis
4. Pregnancy / contraception
* Pregnant, breastfeeding, or desire to become pregnant or unwilling to practice birth control during participation in the study duration, unless surgically sterilized or postmenopausal during the study
