Another Brazilian study, which included 221 patients treated with TNF-inhibitors for ax-SpA and psoriatic arthritis, recorded 11 cases of tuberculosis.10 An Indian study of 195 patients with RA and SpA found 7 cases of tuberculosis.11 Furthermore, data from the French RATIO registry (Research Axed on Tolerance of Biotherapies) showed that the incidence rate of tuberculosis was 116.7 per 100 000 patient-years. Here, TNF is linked to rheumatoid arthritis.