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Biologic agents targeting specific inflammatory pathwaysincluding TNF- inhibitors (adalimumab, etanercept), IL-6 inhibitors (tocilizumab), T-cell costimulation modulators (abatacept), and B-cell depleting agents (rituximab)provide additional options for patients with inadequate response to conventional therapy

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Cortisol normally rises in the early morning hours to prepare the body for waking