The SMR in adalimumab-treated patients with RA was lower than the SMR previously reported for general RA populations naive to anti-TNF therapy in observational studies conducted in the USA, Canada and Spain.52, 53, 54 The SMR for PsA, CD and psoriasis from the adalimumab database were also lower than SMR previously published for these diseases.55, 56, 57. This evidence concerns the gene TNF and rheumatoid arthritis.