Patients attending other clinical trials at the same time. patients who are pregnant or breastfeeding. patients with (ALT/AST> 5ULN, ANC <0.5 (x109/L), Platelet count<50 (x109/L) based on laboratory findings. People with active immune-related rheumatic diseases who have been treated with anti-TNF medications for the last 6 months. People taking immunosuppressive drugs. People who are allergic to adalimumab or other components of the formulation of these drugs. People with active pulmonary tuberculosis or other active bacterial or fungal infections (Based on IGRA, procalcitonin and blood culture) People with heart failure (grades 3 and 4 of NYHA). History of demyelinating diseases in the patient or his/her family

Patients attending other clinical trials at the same time. patients who are pregnant or breastfeeding. patients with (ALT/AST> 5ULN, ANC <0.5 (x109/L), Platelet count<50 (x109/L) based on laboratory findings. People with active immune-related rheumatic diseases who have been treated with anti-TNF medications for the last 6 months. People taking immunosuppressive drugs. People who are allergic to adalimumab or other components of the formulation of these drugs. People with active pulmonary tuberculosis or other active bacterial or fungal infections (Based on IGRA, procalcitonin and blood culture) People with heart failure (grades 3 and 4 of NYHA). History of demyelinating diseases in the patient or his/her family