The ORAL Surveillance was a 4-year, randomized, open-label, non-inferiority, post-authorization safety endpoint trial, compared tofacitinib (5 mg or 10 mg twice daily) with TNF inhibitors (etanercept or adalimumab) in RA patients (aged ≥50 years with at least one additional cardiovascular risk factors).The risks of MACE and cancers (excluding nonmelanoma skin cancer) were higher with the combined tofacitinib doses compared to TNF inhibitors, and the non-inferiority of tofacitinib was not demonstrated (328). The gene discussed is TNF; the disease is cancer.