The third is a trivalent bispecific nanobody, ozoralizumab, which is linked via a Gly-Ser linker with two VHH fragments for anti-tumor necrosis factor alpha (TNF-α) flanking each side of a VHH fragment for anti-human serum albumin (HSA) and has been approved as a biologic for the treatment of rheumatoid arthritis [42]. This evidence concerns the gene ALB and rheumatoid arthritis.