Now and then
Consensus statement on the initiation and continuation of tumour necrosis factor blocking therapies in rheumatoid arthritis*
Josef S Smolena, Ferdinand C Breedveldb, Gerd R Burmesterc, Bernard Combed, Paul Emerye, Joachim R Kaldenf, Lars Klareskogg, Ravinder N Mainih, Raffele Numoi, Leo B A van de Puttej, Piet L C M van Rielj, Vicente Rodriguez-Valverdek
a University
of Vienna, b University of
Leiden, c University of
Charité, Berlin, d University
of Montpellier, e University of
Leeds, f University of Erlangen, g University of Stockholm, h University of Charing Cross,
London, i University of Bari, j University of Nijmegen, k University of Cantabria
Correspondence to: Dr Josef S Smolen, Division of Rheumatology, Department of Internal Medicine III, University of Vienna, Vienna General Hospital, Waehringer Guertel 18-20, A-1090 Vienna, Austria Email: smj@2me.khl.magwien.gv.at
Accepted for publication 4 May 2000
| The first 150 words of the full text of this article appear below. |
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Article |
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This group of rheumatologists gathered in Vienna out of concern about the absence of a uniform view and guidance on the introduction of tumour necrosis factor (TNF)-blocking therapies in our clinics. With our growing experience, evaluation of drug treatment of rheumatoid arthritis (RA), and previous participation in consensus statements,1 we have had the opportunity of discussing the accrued knowledge as well as personal experiences in the use of TNF-blocking agents and of formulating our jointly shared views on:
- Indications for starting TNF-blockade therapy
- Deciding what levels of disease activity would be most appropriate to continue (or discontinue) TNF-blocking therapy.
For the present, TNF blockade should be reserved for patients with RA
whose symptoms and signs are resistant to disease modifying antirheumatic drug (DMARD) treatment. It is generally agreed that all
patients with active disease should be treated with DMARDs, as such
treatment ameliorates symptoms and slows progression of structural
damage.2
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