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Firstly, as previously mentioned, excessive activation of the HPA axis can lead to elevated glucocorticoid levels, which can easily trigger depression

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Genetic backgrounds may also influence patients responses to specific drugs, with certain genetic variations potentially leading to differences in sensitivity to DMARDs or biologic agents

[DOI] [PMC free article] [PubMed] [Google Scholar] 63.Jannatifar R, Parivar K, Roodbari NH, Nasr-Esfahani MH