Within 3 years, 40% of the patients and, within 6 years, almost 50% of the patients showed radiographic changes, especially in the hips, knees, and shoulders.7 Furthermore, another study demonstrated that only 30% of the studied patients exhibited no radiographic abnormalities of the large joints after 12 years of follow-up.8 On the other hand, Seki et al reported that 6% of large joints in patients with RA showed progression of joint damage after 1 year of treatment with TNF-blocking therapy.19 In the present study, 12% of the patients developed radiographic changes after 2 years. The gene discussed is TNF; the disease is rheumatoid arthritis.