TNF-alpha can be elevated in severe asthmatics' sputum and bronchial tissue. Could blocking it help? Holgate et al randomized 132 people with moderate or severe persistent asthma to receive 25 mg etanercept or placebo injections for 12 weeks. There was no difference in the primary endpoint (change in FEV1 at 12 weeks) nor in exacerbations, Asthma Control Questionnaire and quality of life scores, or methacholine concentration needed to provoke bronchoconstriction. (n=132) ERJ 2011;37:1352-1359.