The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis treatment recommendations for PsA places csDMARDs on the same line with bDMARDs and targeted synthetic DMARDs (tsDMARDs) when treating DMARD-naïve peripheral PsA [17], while the ACR’s 2018 guidelines for treatment for PsA recommend TNF-inhibitor biologics over csDMARDs for treatment-naïve patients in certain cases [18]. The gene discussed is TNF; the disease is psoriatic arthritis.