However, the beneficial effect on endothelial dysfunction does not seem to be specific of anti-TNF-alpha drugs as therapy with rituximab, a monoclonal antibody that selectively targets CD20 positive B cells, demonstrated in two different studies an early and sustained favorable effect on endothelial function in RA patients refractory to TNF-alpha blockers [17, 24]. Here, TNF is linked to endothelial dysfunction.