With the advent and success of antitumour necrosis factor (TNF) and other biological therapies, investigators have sought to define the place of concomitant immunomodulator therapy, and its effect on the risk–benefit equation. Early experience suggested that combination therapy was desirable to reduce the immunogenicity of infliximab, especially with episodic dosing. More recently, this approach has been challenged due to a lack of synergistic efficacy and the minimal reduction in immunogenicity when anti-TNF drugs are used …