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Updated consensus statement on biological agents for the treatment of rheumatic diseases, 2009
  1. D E Furst1,
  2. E C Keystone2,
  3. R Fleischmann3,
  4. P Mease4,
  5. F C Breedveld5,
  6. J S Smolen6,
  7. J R Kalden7,
  8. J Braun8,
  9. B Bresnihan9,
  10. G R Burmester10,
  11. F De Benedetti11,
  12. T Dörner12,
  13. P Emery13,
  14. A Gibofsky14,
  15. A Kavanaugh15,
  16. B Kirkham16,
  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,
  23. K Winthrop23
  1. 1
    University of California at Los Angeles, Los Angeles, USA
  2. 2
    University of Toronto, Toronto, Canada
  3. 3
    University of Texas Southwestern Medical Center, Texas, USA
  4. 4
    Seattle Rheumatology Associate, Seattle, USA
  5. 5
    Leiden University Medical Centre, Leiden, The Netherlands
  6. 6
    2nd Department of Medicine, Krankenhaus Lainz, and Department of Rheumatology, Internal Medicine III, Medical University of Vienna, Vienna, Austria
  7. 7
    University Erlangen-Nuremberg, Erlangen, Germany
  8. 8
    Rheumazentrum Ruhrgebiet, Germany
  9. 9
    Rheumatology Department, St Vincents Hospital, Dublin, Ireland
  10. 10
    Department of Rheumatology, Charite-University Medicine, Berlin, Germany
  11. 11
    Laboratorio di Reumatologia, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
  12. 12
    Institut für Transfusionsmedizin, Klinische Hämostaseologie, Charite Universitätsmedizin Berlin, Berlin, Germany
  13. 13
    Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital, Leeds, UK
  14. 14
    Rheumatology/Medicine Hospital for Special Surgery, New York, New York, USA
  15. 15
    University California San Diego, Rheumatology/Allergy Immunology, La Jolla, California
  16. 16
    Rheumatology Department/Guys Hospital, London, UK
  17. 17
    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
  23. 23
    Oregon Health and Science University, Oregon, USA
  1. Correspondence to Professor D E Furst, David Geffen School of Medicine, UCLA – RM 32-59, 1000 Veteran Avenue, Los Angeles, CA 90025, USA; defurst{at}mednet.ucla.edu

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As in previous years, the consensus group to consider the use of biological agents in the treatment of rheumatic diseases met during the 11th 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 to supply 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 abatacept,1 B-cell-specific agents,2 interleukin 1 receptor antagonists (IL1ra),3 tocilizumab (TCZ),4 and tumour necrosis factor α (TNFα) blocking agents,5 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 the appendix.6 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 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 …

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