In this study, RF and anti-CCP titers at W54 were significantly decreased in all three IFX dosing groups compared with those at W0 (Additional file 3), suggesting that a “vicious cycle” might exist in patients with RA whereby RF/anti-CCP promotes TNF production, which in turn contributes to further induction of RF/anti-CCP through an as yet unknown mechanism. This evidence concerns the gene TNF and rheumatoid arthritis.