TNF and rheumatoid arthritis: A protective effect has been reported with the use of hydroxychloroquine 40 and other DMARDs when initiated within the first 3 months of RA diagnosis.12 Regarding treatment with corticosteroids, many studies suggest an increased risk of cardiovascular events in patients with long-term use of corticosteroids.41 Other authors have also reported a favorable impact of TNF antagonists in reducing the effects of cardiovascular events when initiated at early stages of the disease.22,41,42