In particular, Adami et al. found a reduction in Dkk-1 serum levels in RA patients after 6 months of anti-TNFα treatment (most patients were treated with adalimumab and certolizumab, less with etanercept, infliximab and golimumab); they did not observe any changes in sclerostin serum levels, therefore suggesting that the changes of Dkk-1 were not associated with a feedback with sclerostin [62]. This evidence concerns the gene DKK1 and rheumatoid arthritis.