Further advances in understanding the cellular and molecular composition of the rheumatoid synovium were derived from transcriptomic data of another large biopsy-based study, the “Rituximab versus tocilizumab in anti-TNF inadequate responder patients with rheumatoid arthritis” (R4-RA trial) [175]; this was the first randomised controlled biopsy-driven trial worldwide. The gene discussed is TNF; the disease is rheumatoid arthritis.