TNF and atherosclerosis: Taking these observations together, in an attempt to further investigate the potential beneficial effect of TNF-alpha antagonist therapy on subclinical atherosclerosis in RA, we sought to determine whether adalimumab therapy might yield persistent improvement of endothelial function and no morphological progression of subclinical atherosclerosis measured by the determination of carotid artery IMT in RA patients with severe disease, refractory to DMARDs, who were prospectively followed over 1 year period.