Biological DMARDs, as the preferred alternative treatment for patients who fail cDMARD therapy, have been confirmed to modify the circulating miRNA expression profile in RA.233 In patients with RA who responded well to TNF inhibitor (TNFi)/cDMARD combination treatment, serum miR-23a-3p and miR-223-3p expression was decreased at baseline and significantly increased after 3 months of treatment.262 The circulating miR-22, miR-27-3p and miR-886-3p concentrations in patients with RA prior to the initiation of adalimumab/MTX combination therapy are pivotal predictors of a good clinical response. This evidence concerns the gene TNF and rheumatoid arthritis.