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Updated consensus statement on biological agents for the treatment of rheumatic diseases, 2011
  1. D E Furst1,
  2. E C Keystone2,
  3. J Braun3,
  4. F C Breedveld4,
  5. G R Burmester5,
  6. F De Benedetti6,
  7. T Dörner7,
  8. P Emery8,
  9. R Fleischmann9,
  10. A Gibofsky10,
  11. J R Kalden11,
  12. A Kavanaugh12,
  13. B Kirkham13,
  14. P Mease14,
  15. J Sieper15,
  16. N G Singer16,
  17. J S Smolen17,
  18. P L C M Van Riel18,
  19. M H Weisman19,
  20. K Winthrop20
  1. 1Rheumatology Department, University of California at Los Angeles, Los Angeles, California, USA
  2. 2Rheumatology Department, University of Toronto, Toronto, Canada
  3. 3Rheumazentrum Ruhrgebiet, Herde, Germany
  4. 4Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
  5. 5Department of Rheumatology and Clinical Immunology, Charite-University Medicine, Berlin, Germany
  6. 6Laboratorio di Reumatologia, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
  7. 7Institut für Transfusionsmedizin, Klinische Hämostaseologie, Charite Universitätsmedizin Berlin, Berlin, Germany
  8. 8Section of Musculoskeletal Disease Biomedical Research Unit, Leeds Institute of Molecular Medicine and Teaching Hospitals Trust, University of Leeds, Leeds, UK
  9. 9Rheumatology Department, University of Texas Southwestern Medical Center, Dallas, Texas, USA
  10. 10Rheumatology/Medicine Hospital for Special Surgery, New York, New York, USA
  11. 11Institute for clinical Immunology and Rheumatology, University Erlangen-Nuremberg, Erlangen, Germany
  12. 12University California San Diego, Rheumatology/Allergy Immunology, La Jolla, San Diego, California, USA
  13. 13Rheumatology Department, Guys Hospital, London, UK
  14. 14Seattle Rheumatology Associate, Swedish Medical Center and University of Washington, Seattle, Washington, USA
  15. 15Department of Medicine/Rheumatology, Charite Campus Benjamin Franklin, Berlin, Germany
  16. 16Division of Rheumatology, MetroHealth Medical Center/Case Western Reserve Society, Cleveland, Ohio, USA
  17. 172nd Department of Medicine, Krankenhaus Lainz, and Department of Rheumatology, Internal Medicine III, Medical University of Vienna, Vienna, Austria
  18. 18Rheumatology Department, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands
  19. 19Division of Rheumatology, Cedars Sinai Medical Center, Los Angeles, California, USA
  20. 20Division of Infectious Diseases, Oregon Health and Science University, Portland, Oregon, USA
  1. Correspondence to Professor D E Furst, Rheumatology Department, David Geffen School of Medicine, UCLA – RM 32-59, 1000 Veteran Avenue, Los Angeles, California 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 13th Annual Workshop on Advances in Targeted Therapies in April, 2011. 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 (IL-1) antagonists, tocilizumab (TCZ) and tumour necrosis factor α blocking agents (TNF inhibitors), an update of the previous consensus statement is appropriate. To allow ease of updating, the 2010 (data from March 2009 to January 2010) updates are incorporated into the body of the article, while 2011 updates (February 2010–January 2011) 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 appendix 1.1 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 …

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