We will soon see the outcomes of such initiatives [including STRAP—Stratification of Biologic Therapies for RA by Pathobiology (ISRCTN10618686) and R4-RA—A Randomized, open labeled study in anti-TNFa inadequate responders to investigate the mechanisms for Response—Resistance to Rituximab vs. Tocilizumab in RA (ISRCTN97443826)] that will inform future tissue driven trial design. The gene discussed is TNF; the disease is rheumatoid arthritis.