In 2019, interim results from an ongoing, open-label, randomized, post-authorization safety study (Study A3921133; NCT02092467) in RA patients aged 50 years or older and who were at an increased risk for cardiovascular adverse events suggested that TOF increases the risk of serious and fatal infections compared to the TNF inhibitors adalimumab and etanercept in the subset of patients aged 65 years or older16,17. This evidence concerns the gene TNF and infection.