Exercise is a treatment in rheumatoid arthritis but participation in moderate-to-vigorous exercise is challenging for some patients. Light-intensity breaks in sitting could be a promising alternative. We compared the acute effects of active breaks in sitting with those of moderate-to-vigorous exercise on cardiometabolic risk markers in patients with rheumatoid arthritis. In a cross-over fashion, 15 women with rheumatoid arthritis underwent three 8-h experimental conditions: prolonged sitting (SIT), 30-min bout of moderate-to-vigorous exercise followed by prolonged sitting (EX), and 3-min bout of light-intensity walking every 30 min of sitting (BR). Postprandial glucose, insulin, c-peptide, triglycerides, cytokines, lipid classes/subclasses (lipidomics), and blood pressure responses were assessed. Muscle biopsies were collected following each session to assess targeted proteins/genes. Glucose (-28% in area under the curve (AUC), p=0.036), insulin (-28% in AUC, p=0.016) and c-peptide (-27% in AUC, p=0.006) postprandial responses were attenuated in BR vs. SIT, whereas only c-peptide was lower in EX vs. SIT (-20% in AUC, p=0.002). IL-1β decreased during BR, but increased during EX and SIT (p=0.027 and p=0.085). IL-1ra was increased during EX vs. BR (p=0.002). TNF-α concentrations decreased during BR vs. EX (p=0.022). EX, but not BR, reduced systolic blood pressure (p=0.013). Lipidomic analysis showed that 7 of 36 lipid classes/subclasses were significantly different between conditions, with greater changes being observed in EX. No differences were observed for protein/gene expression. Brief active interruptions to sitting can offset markers of cardiometabolic disturbance, which may be particularly useful for patients who may find it difficult to adhere to exercise.