Anti-TNF therapy restores the hypothalamic-pituitary-adrenal axis.

Tumor necrosis factor (TNF) inhibitors are associated with greater improvements in the symptoms and signs of rheumatoid arthritis (RA) and, more importantly, a lower risk of joint damage. TNF is an important mediator of the alterations in neuroendocrine axes characterizing RA. Long-term therapy with anti-TNF agents sensitizes the pituitary gland and improves adrenal androgen secretion, thus stimulating an alternative form of anti-inflammatory action.