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As the second leading cause of adult-onset sensorineural deafness (Mathers et al., 2000), noise-induced hearing loss (NIHL) is a preventable condition that represents a large worldwide economic burden, as well as a health priority (World Health Organization, 1997, 2018

The decision to prescribe should involve individualized risk-benefit assessment, considering the patient's specific autoimmune diagnosis, disease activity, concurrent immunosuppressive medications, and overall health status

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