Is there utility of modifying DMARD treatment in a seropositive rheumatoid arthritis patient with recurrent pleural effusions and RA nodules without other signs of active disease?  

Modifying DMARD treatment in a seropositive RA patient without active articular disease may be useful when the patient has symptomatic noninfectious recurrent pleural effusions that are exudative requiring repetitive thoracentesis, frequent courses of systemic or intrapleural corticosteroids. Rheuma...

If a patient with Rheumatoid Arthritis on DMARDS is having recurrent pleural effusions, I find adding a TNF inhibitor stops that.