This dual pathway inhibition in combination therapy leads to markedly reduced levels of pro-inflammatory cytokines, including IL-6, TNF-α, and IL-17, compared with monotherapy, thereby retarding joint destruction.[29] This study demonstrates that the levels of IL-1β and IL-6 in patients with RA treated with DMARDs combined with biologics were higher than those in patients treated with DMARDs alone, which may suggest the enhancement of inflammation in patients with RA treated with DMARDs combined with biologics. This evidence concerns the gene TNF and rheumatoid arthritis.