Rheumatoid arthritis (RA) is a chronic, progressive, autoimmune disease. Th e main role in the pathogenesis of RA is played by interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α). The objectives of this study were to compare the efficacy of tocilizumab and TNF-α inhibitors in RA patients who did not receive previous biological therapy, to determine how parameters of inflammation changed within each group and between the two groups, and to analyze drug retention rates after 18 months of treatment. The research included 26 patients (10 tocilizumab, 16 TNF-α inhibitors) who started biological therapy in the period between January 2011 and June 2015 and were followed for 18 months. The recorded parameters were C-reactive protein (CRP), the Disease Activity Score 28 (DAS 28 score), and the number of tender and swollen joints. Aft er 3 months of treatment the DAS 28 score was significantly lower in patients treated with tocilizumab compared with patients treated with TNF-α inhibitors (P=0.009). In both patient groups the number of tender joints was significantly reduced. In patients treated with tocilizumab the number of swollen joints was significantly reduced aft er 3 months of tocilizumab treatment, while in patients treated with TNF-α inhibitors this change was not observed. Th e mean values of CRP in both groups did not diff er significantly during the study period. In the patients treated with tocilizumab there was no discontinuation of treatment, while in patients treated with TNFα inhibitors therapy was interrupted in 7 patients (44%). Remission in RA patients occurred as soon as 3 months aft er tocilizumab treatment, while in patients treated with TNF-α inhibitors it occurred within a period of 3 to 6 months.