TNF and systemic lupus erythematosus: TNF-α inhibitors remain the therapeutic class most often associated with ANA seroconversion, anti-dsDNA induction, anti-TNF-induced lupus, CLE exacerbation, and SLE flares [10,18,22,23,24,25,33,34,38,42,43,44,45], highlighting the need for careful risk–benefit assessment in lupus-prone settings.