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While their efficacies are not in doubt, however their cost is prohibitive, and adverse effects are sometimes seen. This review describes the evolution of biotherapy, mode of action of biologics, indications for their use and challenges. It also gives our experience in the use of these agents among Nigerian patients seen in a private practice rheumatology clinic between 2007-2019. Stroke is the second leading cause of death worldwide. Stroke mortality has been shown to be higher in blacks in multiracial studies. It is also a very impor
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