For example, the dimeric form of anti-TNF VHH was up to 500 times more active than the monovalent form in rheumatoid arthritis model in vivo (28), homotrimeric molecule of anti-SARS-CoV-2 nanobody Nb213 were 30-fold more potent in pseudovirus neutralization (14), dimeric forms of nanobodies to botulinum neurotoxin showed a higher protective activity in vivo (29). This evidence concerns the gene TNF and rheumatoid arthritis.