Despite the absence of randomized controlled studies examining the effects of anti-TNF drugs on patients with SSc or SSc-ILD, observational studies conducted in the early 2000s indicated that anti-TNF drugs, especially infliximab and etanercept, may improve inflammatory arthritis and disability in patients with SSc and SSc-associated interstitial lung disease (SSc-ILD) [219]. This evidence concerns the gene TNF and interstitial lung disease.