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Updated consensus statement on biological agents for the treatment of rheumatoid arthritis and other rheumatic diseases (May 2002)
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  1. D E Furst1,
  2. F C Breedveld2,
  3. J R Kalden3,
  4. J S Smolen4,
  5. C E Antoni5,
  6. J W J Bijlsma6,
  7. G R Burmester7,
  8. B Cronstein8,
  9. E C Keystone9,
  10. A Kavanaugh10,
  11. L Klareskog11
  1. 1University of California, Los Angeles, CA, USA
  2. 2Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
  3. 3Medizinische Klinik III, Friedrich Alexander Universität, Erlangen, Germany
  4. 4Abteilung für Rhumatologie, Universitätsklinik für Innere Medizin III, Wien, Austria
  5. 5Medizinische Klinik III, Friedrich Alexander Universität, Erlangen, Germany
  6. 6Department of Rheumatology, University Medical Centre Utrecht, Utrecht, The Netherlands
  7. 7Department of Rheumatology and Clinical Immunology, Charité Hospital, Berlin, Germany
  8. 8New York University School of Medicine, New York, NY, USA
  9. 9Department of Rheumatology, Mount Sinai Hospital, Toronto, Ontario, Canada
  10. 10Division of Rheumatology, University of California, San Diego, La Jolla, CA, USA
  11. 11Rheumatology Unit, Department of Medicine, Karolinska Hospital, Stockholm, Sweden
  1. Correspondence to:
    Dr D E Furst, 1000 Veteran Avenue Rehabilitation Center, Room 32–5, Los Angeles, CA 90024, USA;
    defurst{at}mednet.ucla.edu

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A s in previous years, the consensus group to consider the use of biological agents was formed by an organising committee constituted of rheumatologists from the Universities of Erlangen, Leiden, and Vienna in Europe in cooperation with universities in the United States, Canada, and Europe. Pharmaceutical industry support was obtained from a number of companies, but these institutions had no part in the decisions about the specific programme or about the academic participants at this conference.

The 158 rheumatologists and bioscientists from 22 countries who attended the consensus conference were chosen from a worldwide group of people felt to have experience or interest in the use of biological agents for the treatment of 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 documenting possible new and unexpected adverse events. In addition, the first of a new class of targeted biological agents, interleukin 1 (IL1) blocking agents, has become available. Therefore an update of the previous consensus statement1 seems both appropriate and necessary.

In the present update 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 3.2 All participants reviewed relevant clinical published articles relating to tumour necrosis factor (TNF) and IL1 blocking agents. They were given a draft consensus statement and were asked to revise the document in small discussion groups; open discussion of the revisions led to a final document, representing this updated consensus statement.

General statements

Individual patients differ in the aggressiveness of their …

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