AIM:To investigate the influence,if any,of tumor necrosis factor(TNF)-αinihibitors and Tocilizumab,on hepatic steatosis(HS)in rheumatoid arthritis(RA)patients in the light of the known role of TNF-αand interleukin-6,which are key-cytokines in the pathogenesis of RA,in inducing HS in general population.METHODS:We retrospectively reviewed the clinical charts of 36 RA patients,out of whom 12 had been treated with Methotrexate(MTX),12 with TNF inhibitors±MTX and 12 with Tocilizumab±MTX.The 3 subgroups of patients matched each other for sex,age,body mass index,metabolic syndrome(MS)and other risk factors for atherosclerosis.At baseline and after 12 mo each patient underwent an abdominal ultrasonog-raphy for the assessment of presence of HS and the evaluation of its grade.RESULTS:No difference was detected either in the prevalence of HS or in that of its distinct grades between the 3 groups of patients at baseline.After 12 mo,the HS grade unchanged in 20 patients(7 subjects treated with MTX,7 with TNF-αinhibitors±MTX and 6 Tocilizumab±MTX);increased in 12 patients(4 subjects treated with MTX,4 TNF-αblockers±MTX and 4 Tocilizumab±MTX);decreased in 4(1 treated with MTX,1 with anti-TNF-α+MTX and 2 with TCZ±MTX(P=0.75).No correlation was found between getting remission or low disease activity and the course of either MS or HS.CONCLUSION:We failed to detect any influence of MTX±TNF-αinhibitors or Tocilizumab in reducing MS and HS.A prospective study is needed to clarify the topic.