Still, the compliance rate of an anti-TNF therapy is rather low in Brazil, i.e. after 1 year, 48.2% of RA patients continued using anti-TNF (± csDMARD) therapy, and at the end of the second year, only 23.1% of anti-TNF (± csDMARD) users were still on the medication [34]. This evidence concerns the gene TNF and rheumatoid arthritis.