TNF and rheumatoid arthritis: We found that, RA patients with normal cIMT had longer disease duration and lower levels of TNFα and IL-6 (Table 1) probably due to the benefit of prolonged use of antirheumatic drugs in the prevention of subclinical atherosclerosis [22]. In vitro studies using methotrexate (MTX) favor the cholesterol efflux through activation of adenosine A2 receptor, which in turn prevents the foam cell differentiation and atherosclerosis plaque formation [23, 24].