While such trials demonstrate the ability of anti-TNFs to slow radiographic progression and improve the signs and symptoms of RA in patients with active disease, studies which permit the inclusion of more diverse patient groups such as those with and without prior anti-TNF use, with and without baseline methotrexate (MTX) use or with prior exposure to non-MTX conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) would more accurately reflect patients in real-world clinical care. Here, TNF is linked to rheumatoid arthritis.