The circulating tumour necrosis factor-alpha (TNFα) inhibitors levels did not decrease in rheumatoid arthritis (RA) patients treated with TNFα inhibitors, notwithstanding the clinical and biochemical improvement, as elucidated in 'Inflammopharmacology'.

The use of TNFα inhibitors has shown to improve the outcomes of RA treatment. This present study by Dorota Sikorska et al. focused on revealing whether the serum levels of TNFα during therapy with TNFα inhibitors do really reflect the disease activity and correspond to the pain intensity experienced.

Total of 30 RA patients was investigated before and after 12 weeks of routine therapy using the TNFα inhibitors. Serum levels of TNFα were calculated using a high-sensitivity immunoassay and was related to the patients' clinical and biochemical status. The modified disease activity score (DAS28) helped to estimate the disease activity.

There was a 13% median relative change observed in TNFα. The patients were grouped as per this median value as below or above the value. In terms of baseline characteristics and response to the therapy, the patients did not exhibit any differences. Although the patients who found to have tender joints had increased serum TNFα after treatment. Thus a correlation was established between the number of tender joints after the treatment and absolute TNFα concentrations. These numbers change with the change in the levels of serum TNFα. It can be concluded that the circulating TNFα is responsible for the persistence of joint pain in the patients treated with TNFα inhibitors as there was no decrease in the circulating TNFα levels in them. But this treatment showed significant clinical and biochemical improvements in RA patients.