Included patients were men and women, aged 20 years or older, with RA diagnosed according to the 2010 American College of Rheumatology/European League Against Rheumatism (EULAR) classification criteria [24], who had a history of being refractory to treatment with csDMARDs, were naïve to treatment with bDMARDs, and who provided written informed consent. Excluded patients were those with malignant tumors, active infections, pregnancy, or those deemed ineligible for study participation by the physician.
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