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2013, and FDA's December 2024 review lists the same trial set

Although initially thought that syndesmophytes formation was not hindered, but even accelerated, by anti-TNFs [44], newer long-term data have questioned this hypothesis [45]

and c) irregular dietary patterns), reduced bioavailability (impairment of the intrinsic factor-mediated absorption pathway, often due to the widespread and prolonged use of proton pump inhibitors), and malabsorption syndromes