TNF and tuberculosis: Methotrexate is an immunosuppressant in combination with a TNF-α inhibitor that can eliminate antidrug antibodies and restore clinical response (Ben-Horin et al., 2013), but hepatotoxicity and reactivation of tuberculosis of methotrexate greatly limit its use (Lorenzetti et al., 2014; Vallejo-Yagüe et al., 2021).