Rheumatoid arthritis that was resistant to methotrexate and sulfasalazine developed in a 25-year-old woman who was evaluated for possible treatment with a tumor necrosis factor inhibitor. These agents are effective in some patients who have not had a response to other therapies. They increase the risk of infection, and their long-term efficacy and safety are not established.
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Scott et al. (2006) studied this question.
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