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Biologic disease-modifying anti-rheumatic drugs (DMARDs), including TNF- and IL-6 inhibitors, have become critical for targeting specific pro-inflammatory cytokines, effectively suppressing the inflammatory cascade and reducing bone loss

Inclusion and ethics statement The study presented here, has been approved and annually reviewed by the ethics board of the Ministry of Health of the Democratic Republic of the Congo (DRC) and the IRB board of the Oregon Health and Sciences University

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