The gastrointestinal microbiota can influence the event of RA by proximal intestinal immunomodulatory cells, which can be present in unique locations within the intestine. Further procedure alternatives which include bDMARDs, tsDMARDs, biosimilars or mix therapy are available when csDMARDs are ineffective or poorly tolerated. bDMARDs are a more moderen selection https://www.directivepublications.org/journal-of-arthritis-and-rheumatology/