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Mechanisms of disease: metabolic effects of growth hormone and insulin-like growth factor 1

In refractory cases, third-line options typically include thalidomide, lenalidomide, belimumab, and intravenous immunoglobulin (IVIG), with mixed case series supporting use of anifrolumab, rituximab, deucravacitinib, litifilimab, plasmapheresis or photopheresis, and baricitinib