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Updated consensus statement on tumour necrosis factor blocking agents for the treatment of rheumatoid arthritis and other rheumatic diseases (April 2001)
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  1. D E FURST
  1. Arthritis Clinical Research Unit
  2. Virginia Mason Research Centre, Seattle, WA, USA
  3. Department of Rheumatology
  4. Mount Sinai Hospital
  5. Toronto, Ontario, Canada
  6. Department of Rheumatology
  7. Leiden University Medical Centre
  8. Leiden, Netherlands
  9. Medizinische Klinik III
  10. Friedrich Alexander Universität
  11. Erlangen, Germany
  12. Abteilung für Rhumatologie
  13. Universitätsklinik für Innere Medizin III
  14. Wien, Austria
  15. Department of Medicine
  16. Univ Erlangen-Nurnberg
  17. Erlangen, Germany
  18. Department of Rheumatology and Clinical Immunology
  19. Charité Hospital
  20. Berlin, Germany
  21. Department of Rheumatology
  22. University of Michigan
  23. Ann Arbor, MI, USA
  24. Division of Rheumatology
  25. University of California
  26. San Diego, La Jolla, CA, USA
  1. Dr D E Furst, Virginia Mason Research Centre, 1201 9th Avenue, Mailstop R1-RHE, Seattle, WA 98101, USA
  1. E C KEYSTONE
  1. Arthritis Clinical Research Unit
  2. Virginia Mason Research Centre, Seattle, WA, USA
  3. Department of Rheumatology
  4. Mount Sinai Hospital
  5. Toronto, Ontario, Canada
  6. Department of Rheumatology
  7. Leiden University Medical Centre
  8. Leiden, Netherlands
  9. Medizinische Klinik III
  10. Friedrich Alexander Universität
  11. Erlangen, Germany
  12. Abteilung für Rhumatologie
  13. Universitätsklinik für Innere Medizin III
  14. Wien, Austria
  15. Department of Medicine
  16. Univ Erlangen-Nurnberg
  17. Erlangen, Germany
  18. Department of Rheumatology and Clinical Immunology
  19. Charité Hospital
  20. Berlin, Germany
  21. Department of Rheumatology
  22. University of Michigan
  23. Ann Arbor, MI, USA
  24. Division of Rheumatology
  25. University of California
  26. San Diego, La Jolla, CA, USA
  1. Dr D E Furst, Virginia Mason Research Centre, 1201 9th Avenue, Mailstop R1-RHE, Seattle, WA 98101, USA
  1. F C BREEDVELD
  1. Arthritis Clinical Research Unit
  2. Virginia Mason Research Centre, Seattle, WA, USA
  3. Department of Rheumatology
  4. Mount Sinai Hospital
  5. Toronto, Ontario, Canada
  6. Department of Rheumatology
  7. Leiden University Medical Centre
  8. Leiden, Netherlands
  9. Medizinische Klinik III
  10. Friedrich Alexander Universität
  11. Erlangen, Germany
  12. Abteilung für Rhumatologie
  13. Universitätsklinik für Innere Medizin III
  14. Wien, Austria
  15. Department of Medicine
  16. Univ Erlangen-Nurnberg
  17. Erlangen, Germany
  18. Department of Rheumatology and Clinical Immunology
  19. Charité Hospital
  20. Berlin, Germany
  21. Department of Rheumatology
  22. University of Michigan
  23. Ann Arbor, MI, USA
  24. Division of Rheumatology
  25. University of California
  26. San Diego, La Jolla, CA, USA
  1. Dr D E Furst, Virginia Mason Research Centre, 1201 9th Avenue, Mailstop R1-RHE, Seattle, WA 98101, USA
  1. J R KALDEN
  1. Arthritis Clinical Research Unit
  2. Virginia Mason Research Centre, Seattle, WA, USA
  3. Department of Rheumatology
  4. Mount Sinai Hospital
  5. Toronto, Ontario, Canada
  6. Department of Rheumatology
  7. Leiden University Medical Centre
  8. Leiden, Netherlands
  9. Medizinische Klinik III
  10. Friedrich Alexander Universität
  11. Erlangen, Germany
  12. Abteilung für Rhumatologie
  13. Universitätsklinik für Innere Medizin III
  14. Wien, Austria
  15. Department of Medicine
  16. Univ Erlangen-Nurnberg
  17. Erlangen, Germany
  18. Department of Rheumatology and Clinical Immunology
  19. Charité Hospital
  20. Berlin, Germany
  21. Department of Rheumatology
  22. University of Michigan
  23. Ann Arbor, MI, USA
  24. Division of Rheumatology
  25. University of California
  26. San Diego, La Jolla, CA, USA
  1. Dr D E Furst, Virginia Mason Research Centre, 1201 9th Avenue, Mailstop R1-RHE, Seattle, WA 98101, USA
  1. J S SMOLEN
  1. Arthritis Clinical Research Unit
  2. Virginia Mason Research Centre, Seattle, WA, USA
  3. Department of Rheumatology
  4. Mount Sinai Hospital
  5. Toronto, Ontario, Canada
  6. Department of Rheumatology
  7. Leiden University Medical Centre
  8. Leiden, Netherlands
  9. Medizinische Klinik III
  10. Friedrich Alexander Universität
  11. Erlangen, Germany
  12. Abteilung für Rhumatologie
  13. Universitätsklinik für Innere Medizin III
  14. Wien, Austria
  15. Department of Medicine
  16. Univ Erlangen-Nurnberg
  17. Erlangen, Germany
  18. Department of Rheumatology and Clinical Immunology
  19. Charité Hospital
  20. Berlin, Germany
  21. Department of Rheumatology
  22. University of Michigan
  23. Ann Arbor, MI, USA
  24. Division of Rheumatology
  25. University of California
  26. San Diego, La Jolla, CA, USA
  1. Dr D E Furst, Virginia Mason Research Centre, 1201 9th Avenue, Mailstop R1-RHE, Seattle, WA 98101, USA
  1. C E ANTONI
  1. Arthritis Clinical Research Unit
  2. Virginia Mason Research Centre, Seattle, WA, USA
  3. Department of Rheumatology
  4. Mount Sinai Hospital
  5. Toronto, Ontario, Canada
  6. Department of Rheumatology
  7. Leiden University Medical Centre
  8. Leiden, Netherlands
  9. Medizinische Klinik III
  10. Friedrich Alexander Universität
  11. Erlangen, Germany
  12. Abteilung für Rhumatologie
  13. Universitätsklinik für Innere Medizin III
  14. Wien, Austria
  15. Department of Medicine
  16. Univ Erlangen-Nurnberg
  17. Erlangen, Germany
  18. Department of Rheumatology and Clinical Immunology
  19. Charité Hospital
  20. Berlin, Germany
  21. Department of Rheumatology
  22. University of Michigan
  23. Ann Arbor, MI, USA
  24. Division of Rheumatology
  25. University of California
  26. San Diego, La Jolla, CA, USA
  1. Dr D E Furst, Virginia Mason Research Centre, 1201 9th Avenue, Mailstop R1-RHE, Seattle, WA 98101, USA
  1. G R BURMESTER
  1. Arthritis Clinical Research Unit
  2. Virginia Mason Research Centre, Seattle, WA, USA
  3. Department of Rheumatology
  4. Mount Sinai Hospital
  5. Toronto, Ontario, Canada
  6. Department of Rheumatology
  7. Leiden University Medical Centre
  8. Leiden, Netherlands
  9. Medizinische Klinik III
  10. Friedrich Alexander Universität
  11. Erlangen, Germany
  12. Abteilung für Rhumatologie
  13. Universitätsklinik für Innere Medizin III
  14. Wien, Austria
  15. Department of Medicine
  16. Univ Erlangen-Nurnberg
  17. Erlangen, Germany
  18. Department of Rheumatology and Clinical Immunology
  19. Charité Hospital
  20. Berlin, Germany
  21. Department of Rheumatology
  22. University of Michigan
  23. Ann Arbor, MI, USA
  24. Division of Rheumatology
  25. University of California
  26. San Diego, La Jolla, CA, USA
  1. Dr D E Furst, Virginia Mason Research Centre, 1201 9th Avenue, Mailstop R1-RHE, Seattle, WA 98101, USA
  1. L J CROFFORD
  1. Arthritis Clinical Research Unit
  2. Virginia Mason Research Centre, Seattle, WA, USA
  3. Department of Rheumatology
  4. Mount Sinai Hospital
  5. Toronto, Ontario, Canada
  6. Department of Rheumatology
  7. Leiden University Medical Centre
  8. Leiden, Netherlands
  9. Medizinische Klinik III
  10. Friedrich Alexander Universität
  11. Erlangen, Germany
  12. Abteilung für Rhumatologie
  13. Universitätsklinik für Innere Medizin III
  14. Wien, Austria
  15. Department of Medicine
  16. Univ Erlangen-Nurnberg
  17. Erlangen, Germany
  18. Department of Rheumatology and Clinical Immunology
  19. Charité Hospital
  20. Berlin, Germany
  21. Department of Rheumatology
  22. University of Michigan
  23. Ann Arbor, MI, USA
  24. Division of Rheumatology
  25. University of California
  26. San Diego, La Jolla, CA, USA
  1. Dr D E Furst, Virginia Mason Research Centre, 1201 9th Avenue, Mailstop R1-RHE, Seattle, WA 98101, USA
  1. A KAVANAUGH
  1. Arthritis Clinical Research Unit
  2. Virginia Mason Research Centre, Seattle, WA, USA
  3. Department of Rheumatology
  4. Mount Sinai Hospital
  5. Toronto, Ontario, Canada
  6. Department of Rheumatology
  7. Leiden University Medical Centre
  8. Leiden, Netherlands
  9. Medizinische Klinik III
  10. Friedrich Alexander Universität
  11. Erlangen, Germany
  12. Abteilung für Rhumatologie
  13. Universitätsklinik für Innere Medizin III
  14. Wien, Austria
  15. Department of Medicine
  16. Univ Erlangen-Nurnberg
  17. Erlangen, Germany
  18. Department of Rheumatology and Clinical Immunology
  19. Charité Hospital
  20. Berlin, Germany
  21. Department of Rheumatology
  22. University of Michigan
  23. Ann Arbor, MI, USA
  24. Division of Rheumatology
  25. University of California
  26. San Diego, La Jolla, CA, USA
  1. Dr D E Furst, Virginia Mason Research Centre, 1201 9th Avenue, Mailstop R1-RHE, Seattle, WA 98101, USA

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As last year, the consensus group to consider the use of tumour necrosis factor (TNF) blocking agents was formed by an organising committee comprising rheumatologists from the universities of Erlangen, Leiden, and Vienna in Europe in cooperation with universities in the United States. Pharmaceutical support was obtained from a number of companies, but these institutions had no part in the decisions about the specific programme nor with regard to the participants or attendees at this conference.

The 148 rheumatologists and bioscientists from 21 countries who attended the consensus conference were chosen from a worldwide group of people felt to have experience or interest in the use of TNF blocking treatment for rheumatoid arthritis (RA) and other rheumatic diseases. Unfortunately, the number of attendees and participants was limited so that not everyone who might have been appropriate could be invited.

Additional information has come to light in the past year, both corroborating the major positive effect these drugs have had in RA and reporting possible new and unexpected adverse events. Therefore an update of the previous consensus statement seems both appropriate and necessary (Ann Rheum Dis 2000;59(suppl I):i1–2).

In this update the consensus statement is annotated to document the credibility of the data supporting it, as far as possible. This annotation is that of Shekelle et al and is described in appendix .1 All participants reviewed relevant clinical published articles relating to the TNF blocking agents. They were given a draft consensus statement and were asked to revise the document; open discussion of the revisions led to a final document, representing this updated consensus statement.

TNF blocking agents differ in composition, precise mechanisms of action, pharmacokinetics, biopharmaceutical properties, etc, but this document emphasises areas of commonality. Data which clearly differentiate compounds will be discussed, if such areas exist.

Indications

Individual patients …

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