TNF and myositis disease: As inhibiting TNF increases type I IFN production, the use of TNF blockers may be a potential trigger for developing or exacerbating inflammatory myopathy.48,49 Although some case reports show a beneficial effect of anti-TNF in myositis, especially in joint or skin predominant disease,50,51 data from retrospective studies reveal an increased risk for ASS and exacerbation of IIM-related ILD.52