Figure 4 Anti‐tumour necrosis factor α (TNFα) monoclonal antibody treatment (adalimumab, 40 mg subcutaneous, every other week) reduces serum interleukin (IL)7 levels in clinical responders, whereas in clinical non‐responders IL7 levels persist. IL7Rα expression levels on T cells and monocytes/macrophages in responders were not significantly changed. (A) Based on the European League Against Rheumatism (EULAR) response criteria, patients were judged as non‐responders (n = 7) and responders (n = 15). As expected, in responders, a strong suppression of disease activity score (DAS) was observed, which was significantly different from that in non‐responders, who showed only modest changes in disease activity. The average absolute DAS score at baseline did not differ significantly between responders and non‐responders (mean (SD), 6.7 (1) vs 5.8 (1.3), respectively). (B) Serum IL7 levels in responders at 2, 6 and 12 weeks significantly decreased on anti‐TNFα treatment compared with those at baseline (100%). Non‐responders did not show significant changes in IL7 levels compared with those at baseline. The difference in percentage change of IL7 levels between responders and non‐responders was significantly different at 2 and 6 weeks after the start of treatment. Baseline IL7 values between anti‐TNFα responders and non‐responders were not significantly different (14.9 (13.6) and 13.2 (10.7) pg/ml, respectively). (C) Serum IL18 levels in responders at 2, 6 and 12 weeks did not significantly alter on anti‐TNFα treatment compared with those at baseline (100%). Baseline IL18 values between anti‐TNFα responders and non‐responders were not significantly different (358 (300) and 557 (487) pg/ml, respectively). (D) IL7Rα expression levels (mean fluorescence intensity (MFI)) on CD4 T cells and CD14 monocytes/macrophages on treatment. No significant change in IL7Rα expression on T cells was observed. The modest IL7Rα expression on monocytes (compared to isotype control, indicated by the dashed line) was only slightly increased in non‐responders after 2 and 6 weeks of anti‐TNFα treatment (both p<0.05). *, ** and *** indicate statistically significant differences of DAS and IL7 compared with those at baseline of p<0.05, p<0.01 and p<0.001, respectively.