TNF and bacterial arthritis: For example, the addition of anti-TNF therapy to DMARDs did not alter the risk of cancer in RA patients selected for anti-TNF therapy [37]; a significantly increased risk of shingles and a doubling in risk of septic arthritis was observed in those treated with anti-TNF therapy but an observed increased risk of serious skin and soft tissue infections was not statistically significant [38, 39] and there was no excess risk of venous thromboembolism [40].