Would you use TNF inhibitor therapy in a patient with seropositive RA who had optic neuritis as a child without relapse as an adult?

This is a really complex question that doesn’t have a simple yes-or-no answer. It involves interpreting a small and complex literature of immunologic and epidemiologic data, along with my own small experience and judgment. That said, I probably wouldn’t use a TNF inhibitor in a patient like this for...