In RA, inadequate response secondary to etanercept (ETN) should be treated with a biologic agent other than TNFi, and after two or more anti-TNF failures, it is recommended to switch to a drug with a different mode of action, such as abatacept (ABA), rituximab (RTX), and tocilizumab (TCZ). The gene discussed is TNF; the disease is rheumatoid arthritis.