CTLA4 and rheumatoid arthritis: Nevertheless, there is some evidence that the use of conventional DMARDs, such as methotrexate, sulfasalazine, hydroxychloroquine, azathioprine, and leflunomide, do impact upon bone mineral density in rheumatoid arthritis, where the use of more targeted biologics, such as anti-TNF (etanercept, adalimumab, golimumab, certolizumab), anti-IL6 receptor (tocilizumab), CTLA4 analog (abatacept), anti-CD 20 (rituximab), and JAK inhibitor (tofacitinib), do not [13].