TNF and rheumatoid arthritis: On the other hand, autoimmune rheumatic diseases (ARD) are also characterised by a dysregulation of the immune system in which several pro-inflammatory cytokines such as IL-1, IL-6, IL-17, and TNFa which are involved in the pathogenesis of rheumatoid arthritis (RA), the spondyloarthropathies (SpA), and inflammatory bowel disease (IBM).5 In the last two decades the introduction of biological (b) disease-modifying anti-rheumatic drugs (DMARDs) targeting cytokines, T and B cells, and with the use of conventional synthetic (cs) DMARDS, has revolutionized the treatment of the above diseases.6,7