However, studies investigating the impact of tocilizumab in response to PPV-23 (Table 1) suggest that tocilizumab did not significantly reduce the antibody response compared with patients receiving other treatments (MTX, anti-TNF, or conventional DMARDs) [100,101,102], Similarly, the humoral response to the conjugate pneumococcal vaccine was similar in RA patients receiving tocilizumab and those not receiving biologic therapy [54]. This evidence concerns the gene TNF and rheumatoid arthritis.