Next line in the treatment of RA TNF inhibitors/TNF blockers are a group of biologic medicines that suppress the body’s response to TNF. TNF (Tumor Necrosis Factor) is a complex protein produced by the white blood cells in response to inflammatory events in the body. Those who have rheumatoid arthritis may be given a TNF inhibitor as part of their therapy. This is the third article in a series about the treatment options for rheumatoid arthritis. You can download the articles or you can read them on Marysarthritis.com. Many insurance plans may require that you start your therapy with a nonbiologic such as methotrexate (MTX). As troublesome as the side effects are in the beginning, methotrexate has a good success rate. When MTX isn’t enough the doctor may order a combination of methotrexate with sulfasalazine and/or leflunomide. A TNF inhibitor may be the added to the methotrexate. Although the TNF inhibitors are basically similar, they do have differentproperties. If one doesn’t work for you, another might. Your doctor will order a TB test and will …