Case series have suggested biological agents targeting TNF-α (e.g. infliximab, adalimumab) can help treat tuberculomas and optochiasmatic arachnoiditis.(96,97) A retrospective cohort study in India reported adjunctive infliximab (10mg/kg 1-3 doses, 4 weeks apart) was safe and effective in treating severe inflammatory complications of TBM.(98) The active TIMPANI trial (NCT05590455) is investigating adjunctive adalimumab in adults with TBM and HIV. This evidence concerns the gene TNF and meningeal tuberculosis.