Rheumatoid arthritis is a chronic autoimmune disease characterised by inflammation of the synovial lining of joints and destruction of cartilage and bone. Many pro-inflammatory cytokines, chemokines and growth factors are expressed in diseased joints, and recognition of the key role of TNF-α led to the development of highly effective new therapies. TNF-α inhibitors, such as monoclonal anti-TNF-α antibody infliximab (Remicade^®), have demonstrated efficacy in clinical trials. It is now clear that TNF-α blockade, in addition to reducing joint inflammation and leukocyte infiltration, also results in decreased formation of new blood vessels in the synovium. Such mechanism of action studies are now paving the way for the development of the next generation of drugs for treatment of rheumatoid arthritis.