In regards to the Finnish study on TNF inhibitor survival, I suspect the results would be even more in the USA as many"sero-negative" RA patients who are presumed to have RA or "inflammatory arthritis" (not to mention the ever-growing number of nr-axSpA patients) receive a trial of empiric therapy with biologic biologic agents that don't pan out. As the saying goes, "you see what you know" and there is a lot we still don't know about this group of" RA-look alikes".