TNF and infection: Biologic DMARDs such as tumor necrosis factor (TNF) blocking agents, anti-interleukin-6 (IL-6) receptor antibody, anti-CD20 antibody, and CTLA4-Ig have significant positive effects on both signs and symptoms and inhibition of structural damage but have a high cost, safety concerns (e.g., infection, allergy, etc.), and inconvenience of intravenous or subcutaneous injection.