TNF and cancer: Notably, in early 2021, both the FDA (https://www.fda.gov/drugs/drug-safety-and-availability/initial-safety-trial-results-find-increased-risk-serious-heart-related-problems-and-cancer-arthritis, accessed on 4 June 2021) and EMA (https://www.ema.europa.eu/en/medicines/dhpc/xeljanz-tofacitinib-initial-clinical-trial-results-increased-risk-major-adverse-cardiovascular, accessed on 4 June 2021) warned about initial trial results showing an increased risk of MACE and malignancies (excluding nonmelanoma skin cancer) with use of tofacitinib in rheumatoid arthritis relative to TNF-alpha inhibitors.