TNF and thrombophilia: It is also important to note that TNF-α blockers block the escape of autoimmune B-cells, causing further upregulation of anticardiolipin antibodies, which inhibits the anticoagulant effects of protein C, protein S, and antithrombin III produced downstream of them and promotes hypercoagulability (Yee and Pochapin, 2001; Ferraccioli and Gremese, 2004; Schreiber et al., 2018).