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IL-6 receptor antagonists Tocilizumab a recombinant anti-human IL-6 receptor monoclonal antibody that binds to both soluble and membrane-bound IL-6 receptors, inhibiting IL-6 mediated signaling the AMBITION clinical trial found that it was slightly superior to methotrexate as monotherapy for RA, but had a slightly higher incidence of side effects (Jones et al, 2010) Janus Kinase Inhibitor Tofacitinib Inhibits cytokine & growth factor signalling by inhibiting Janus kinases, a family of intracellular tyrosine kinases