TNF and Obesity: Indeed, in a study by Schäfer et al. on patients with RA that investigated the relationship between obesity and response to conventional synthetic and biological DMARDs, it was seen that obesity reduced the efficacy of cytokine-targeted treatments such as TNF inhibitor and tocilizumab treatments, whereas such decreased efficacy was not observed for therapeutic agents targeting immune cells, such as rituximab and abatacept treatments [29].