TNF and rheumatoid arthritis: In 2022, the Oral Rheumatoid Arthritis Trial (ORAL surveillance study) found a higher risk of major adverse cardiovascular (CV) events and venous thromboembolic events (TVE) in patients with RA and CV risk factors treated with Xeljanz (tofacitinib) than with Tumor Necrosis Factor inhibitors (TNFi) (20).