Objective: To evaluate efficacy and safety of Actemra (Tocilizumab) in patients with moderate to severe active rheumatoid arthritis (RA) in Bach Mai Hospital from 10/2011 to 8/2012. Patient and Methods: 21 patients were randomly assigned Actemra 4 mg/kg every 4 weeks. The rapid onset and systemic efficacy study was a 12-week (CRP, DAS 28, VAS). Results: The primary efficacy endpoint, significant improvements associated with Actemra were seen in routine assessment of patient index data responses. Rapid improvement in clinical and test outcomes was demonstrated in a substudy as early as week 4 until 12 week as shown by DAS 28 scores from (T0) 5.1 to 2.3 scores (T3), VAS scores from 8.4 (T0) to 3.5 scores (T3), reactive protein C and RF decreased before treatment (P0.01). Safety findings were consistent with the known Actemra safety profile. Conclusions: This study demonstrated the efficacy of Actemra (Tocilizumab) in improving measures of disease activity in patients with RA who failed .to respond adequately to DMARDs therapy.