However, this drug is not effective in all patients, and its effect tends to wane over time.11–13 Importantly, use of anti-TNF monoclonal antibodies (e.g. infliximab) is not advisable due to the potential induction of a severe inflammatory attack.14 More recently, anti-IL1 therapy has proven useful in severe cases of TRAPS and has replaced etanercept as the preferred biologic treatment in this disease.13,15 Moreover, it has been suggested that those at higher risk of amyloidosis may benefit from earlier institution of IL1 inhibition.16 The gene discussed is TNF; the disease is TNF receptor 1-associated periodic fever syndrome.