TNF and systemic lupus erythematosus: Its ability to reduce the production of neutrophil extracellular traps by inhibiting the nicotinamide adenine dinucleotide phosphate oxidation pathway and reducing mitochondrial DNA-induced TNF-a effectively reduces inflammatory responses in SLE (42).Secondly, metformin also reduces the production of TNF-a by inhibiting the AMP-activated protein kinase pathway and reduces fibroblast osteoclastogenesis, reducing the inflammatory responses, which is effective effect in the treatment of AS (43).