Ann Rheum Dis 67:iii2-iii25 doi:10.1136/ard.2008.100834
  • Consensus statement

Updated consensus statement on biological agents for the treatment of rheumatic diseases, 2008

  1. D E Furst1,
  2. E C Keystone2,
  3. B Kirkham3,
  4. R Fleischmann4,
  5. P Mease5,
  6. F C Breedveld6,
  7. J S Smolen7,
  8. J R Kalden8,
  9. G R Burmester9,
  10. J Braun10,
  11. P Emery11,
  12. K Winthrop12,
  13. B Bresnihan13,
  14. F De Benedetti14,
  15. T Dörner15,
  16. A Gibofsky16,
  17. M H Schiff17,
  18. J Sieper18,
  19. N Singer19,
  20. P L C M Van Riel20,
  21. M E Weinblatt21,
  22. M H Weisman22
  1. 1
    University of California at Los Angeles, Los Angeles, USA
  2. 2
    University of Toronto, Toronto, Canada
  3. 3
    Rheumatology Department/ Guys Hospital, London, UK
  4. 4
    University of Texas Southwestern Medical Center, Texas, USA
  5. 5
    Seattle Rheumatology Associate, Seattle, USA
  6. 6
    Leiden University Medical Centre, Leiden, The Netherlands
  7. 7
    2nd Department of Medicine, Krankenhaus Lainz, and Department of Rheumatology, Internal Medicine III, Medical University of Vienna, Vienna, Austria
  8. 8
    University Erlangen-Nuremberg, Erlangen, Germany
  9. 9
    Department of Rheumatology, Charite-University Medicine, Berlin, Germany
  10. 10
    Rheumazentrum Ruhrgebiet, Germany
  11. 11
    Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital, Leeds, UK
  12. 12
    Oregon Health and Science University, Oregon, USA
  13. 13
    Rheumatology Department, St. Vincents Hospital, Dublin, Ireland
  14. 14
    Laboratorio di Reumatologia, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
  15. 15
    Institut für Transfusionsmedizin, Klinische Hämostaseologie, Charite Universitätsmedizin Berlin, Berlin, Germany
  16. 16
    Rheumatology/Medicine Hospital for Special Surgery, New York, New York, USA
  17. 17
    Denver Arthritis Clinic, University of Colorado, Denver, Colorado, USA
  18. 18
    Department of Medicine/Rheumatology, Charite Campus Benjamin Franklin, Berlin, Germany
  19. 19
    Division of Pediatric Infectious Disease and Rheumatology Division of Rheumatic Diseases, Department of Medicine Rainbow, Babies and Children's Hospital, Cleveland, Ohio, USA
  20. 20
    University Hospital Nijmegen, Nijmegen, The Netherlands
  21. 21
    Brigham and Womens Hospital, Boston, Massachusetts, USA
  22. 22
    Cedars Sinai Medical Center, Los Angeles, California, USA
  1. Professor D E Furst, David Geffen School of Medicine, UCLA – RM 32-59, 1000 Veteran Avenue, Los Angeles, CA 90025, USA; defurst{at}
  • Accepted 2 September 2008

As in previous years, the consensus group to consider the use of biological agents in the treatment of rheumatic diseases met during the 10th Annual Workshop on Advances in Targeted Therapies. The group consisted of rheumatologists from a number of universities among the continents of Europe, North America, South America, Australia and Asia. Pharmaceutical industry support was obtained from a number of companies for the annual workshop itself but these companies had no part in the decisions about the specific programme or about the academic participants at this conference. Representatives of the supporting sponsors participated in the initial working groups with emphasis on supplying factual information. The sponsors did not participate in the drafting of the consensus statement.

This consensus was prepared from the perspective of the treating physician.

In view of the new data for tumour necrosis factor α (TNFα) blocking agents, B-cell-specific agents and interleukin 1 receptor antagonists (IL1ra), an update of the previous consensus statement is appropriate. The consensus statement is annotated to document the credibility of the data supporting it as much as possible. This annotation is that of Shekelle et al and is described in an appendix. We have modified the Shekelle annotation by designating all abstracts as “category D evidence”, whether they describe well-controlled trials or not, as details of the study were often not available in the abstracts. Further, the number of possible references has become so large, that reviews are sometimes included; if they contain category A references, they will be referred to as category A evidence.

The 162 rheumatologists and bioscientists who attended the consensus conference were from 23 countries, and were selected for their expertise in the use of biological agents for the treatment of rheumatic diseases. The number of attendees and participants was limited so that not everyone who …