Daniel Furst, MD, professor of medicine, rheumatology, UCLA Health, Los Angeles, California, and Christina Charles-Schoeman, MD, chief of the Division of Rheumatology, UCLA Health, Los Angeles, California, discuss treatment options for patients with rheumatoid arthritis. They discuss combination regimens with methotrexate and TNF inhibitors, but warn about the importance of watching for the activation of underlying diseases, which is a risk with the combination. Drs Furst and Charles-Schoeman look forward to the possibilities for continuing major therapeutic advances, which may include vaccination or gene therapy.