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Updated consensus statement on biological agents for the treatment of rheumatoid arthritis and other immune mediated inflammatory diseases (May 2003)
  1. D E Furst1,
  2. F C Breedveld2,
  3. J R Kalden3,
  4. J S Smolen4,
  5. G R Burmester5,
  6. M Dougados6,
  7. P Emery7,
  8. A Gibofsky8,
  9. A F Kavenaugh9,
  10. E C Keystone10,
  11. L Klareskog11,
  12. A S Russell12,
  13. L B A van de Putte13,
  14. M H Weisman14
  1. 1University of California, UCLA, Rheumatology, Division Los Angeles, USA
  2. 2Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
  3. 3Department of Internal Medicine III, Institut for Clinical Immunology, University of Erlangen-Nuremberg, Erlangen Germany
  4. 4Institute of Rheumatology, Clinic for Internal Medicine III, Vienna General Hospital, Vienna, Austria
  5. 5Department of Rheumatology, and Clinical Immunology, Charité Hospital, Berlin, Germany
  6. 6Institut de Rhumatologie, Hopital Cochin, Paris, France
  7. 7Leeds University, Department of Rheumatology, Leeds General Infirmary, Leeds, United Kingdom
  8. 8Department of Rheumatology, Hospital for Special Surgery, New York, USA
  9. 9Department of Rheumatology, UCSD, La Jolla, CA, USA
  10. 10Department of Rheumatology, Mount Sinai Hospitial, Toronto, Canada
  11. 11Rheumatology Unit, Department of Medicine, Karolinska Hospital, Stockholm, Sweden
  12. 12University of Alberta, Department of Medicine, Heritage Medical Centre, Edmonton, Canada
  13. 13Department of Rheumatology, University Medical Centre Nijmegen, Nijmegen, The Netherlands
  14. 14Division of Rheumatology, Cedars-Sinai Medical Centre, Los Angeles, USA
  1. Correspondence to:
    Dr D Furst; 1000 Veteran Avenue Rehabilitation Centre, Room 32–59, Los Angeles, CA 90024, USA;

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As in previous years, the consensus group to consider the use of biological agents was constituted by 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 21 countries who attended the consensus conference were chosen from a worldwide group of doctors and other scientists interested in the use of biological agents for the treatment of immune mediated inflammatory diseases. The perspective of this consensus is from the treating doctor’s point of view, rather than from the perspective of those paying for their use. 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 rheumatoid arthritis (RA) and other immune mediated inflammatory diseases, as well as documenting possible new and unexpected adverse events. Therefore an update of the previous consensus statement seems both appropriate and necessary (


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 3.99 All participants reviewed relevant clinical published articles relating to tumour necrosis factor (TNF) and interleukin 1 (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.


Individual patients differ in the aggressiveness of …

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    BMJ Publishing Group Ltd and European League Against Rheumatism