TNF and rheumatoid arthritis: In a repeated cross-sectional study of patients with rheumatoid arthritis, the use of methotrexate was associated with a significantly lower clinical and 24-h blood pressure when compared to other csDMARDs.120 Another study of 21,916 patients with rheumatoid arthritis with data from administrative Veterans Affairs databases in United States investigated the changes in blood pressure after commencing methotrexate, leflunomide, sulfasalazine, hydroxychloroquine, TNF-α inhibitors or prednisone.