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Updated consensus statement on biological agents for the treatment of rheumatic diseases, 2010
  1. D E Furst1,
  2. E C Keystone2,
  3. J Braun3,
  4. F C Breedveld4,
  5. G R Burmester5,
  6. F De Benedetti5,
  7. T Dörner5,
  8. P Emery6,
  9. R Fleischmann7,
  10. A Gibofsky8,
  11. J R Kalden9,
  12. A Kavanaugh10,
  13. B Kirkham11,
  14. P Mease12,
  15. J Sieper12,
  16. N G Singer13,
  17. J S Smolen14,
  18. P L C M Van Riel15,
  19. M H Weisman16,
  20. K Winthrop17
  1. 1University of California at Los Angeles, Los Angeles, California, USA
  2. 2University of Toronto, Toronto, Canada
  3. 3Rheumazentrum Ruhrgebiet, Herne, Germany
  4. 4Leiden University Medical Centre, Leiden, The Netherlands
  5. 5Laboratorio di Reumatologia, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
  6. 6Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital, Leeds, UK
  7. 7University of Texas Southwestern Medical Center, Dallas, Texas, USA
  8. 8Rheumatology/Medicine Hospital for Special Surgery, New York, New York, USA
  9. 9University of Erlangen-Nuremberg, Erlangen, Germany
  10. 10Rheumatology/Allergy Immunology, University of California, San Diego, San Diego, California, USA
  11. 11Rheumatology Department/Guys Hospital, London, UK
  12. 12Swedish Medical Center and University of Washington, Seattle, Washington, USA
  13. 13Division of Rheumatology, MetroHealth Medical Center/Case Western Reserve Society, Cleveland, Ohio, USA
  14. 142nd Department of Medicine, Krankenhaus Lainz and Department of Rheumatology, Internal Medicine III, Medical University of Vienna, Vienna, Austria
  15. 15Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands
  16. 16Cedars Sinai Medical Center, Los Angeles, California, USA
  17. 17Oregon Health and Science University, Portland, 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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Introduction

As in previous years, the consensus group to consider the use of biological agents in the treatment of rheumatic diseases met during the 12th Annual Workshop on Advances in Targeted Therapies in April 2010. 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, B cell-specific agents, interleukin 1 antagonists (IL-1), tocilizumab and tumour necrosis factor α (TNFα) blocking agents, an update of the previous consensus statement is appropriate. To allow ease of updating, the 2008 updates (March 2009–February 2009) have been incorporated into the body of the manuscript, while 2010 updates (March 2009–February 2010) are separated and highlighted. 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.1 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 …

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