Furthermore, the potential benefits of DMARDs in RA-ILD treatment remain uncertain, and the use of conventional synthetic DMARDs (csDMARDs) (e.g., methotrexate and leflunomide) and biologic/targeted synthetic DMARDs (b/tsDMARDs) (e.g., tumor necrosis factor [TNF] inhibitors) in RA-ILD treatment is surrounded with controversy. This evidence concerns the gene TNF and rheumatoid arthritis.