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- aCL, anticardiolipin antibodies
- ACR, American College of Rheumatology
- ANA, antinuclear antibodies
- CHF, congestive heart failure
- DAS, disease activity score
- DMARD, disease modifying antirheumatic drug
- HAQ-DI, Health Assessment Questionnaire disability index
- IL, interleukin
- IL1Ra, IL1 receptor antagonist
- MTX, methotrexate
- RA, rheumatoid arthritis
- TNF, tumour necrosis factor
- VAS, visual analogue scale
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.
GENERAL STATEMENTS
Individual patients differ in the aggressiveness of …
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