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Unmet need in rheumatology: reports from the Targeted Therapies meeting 2018
  1. Kevin L Winthrop1,
  2. Michael E Weinblatt2,
  3. Mary K Crow3,
  4. Gerd R Burmester4,
  5. Philip J Mease5,
  6. Alexander K So6,
  7. Vivian Bykerk3,
  8. Ronald F Van Vollenhoven7,
  9. Maxime Dougados8,
  10. Jonathan Kay9,
  11. Xavier Mariette10,
  12. Joachim Sieper11,
  13. Fritz Melchers12,13,
  14. Bruce N Cronstein14,
  15. Ethan Shevach15,
  16. Ferdinand C Breedfeld16,
  17. Joachim Kalden17,
  18. Josef S Smolen18,
  19. Daniel E Furst5,19,20
  1. 1 Oregon Health and Science University, Portland, Oregon, USA
  2. 2 Brigham and Women’s Hospital, Boston, Massachusetts, USA
  3. 3 Hospital for Special Surgery, New York City, New York, USA
  4. 4 Charité-Universitätsmedizin Berlin, Berlin, Germany
  5. 5 Swedish Medical Center, University of Washington, Seattle, Washington, USA
  6. 6 University of Lausanne, Lausanne, Switzerland
  7. 7 Amsterdam Rheumatology and Immunology Center, Amsterdam, Netherlands
  8. 8 Hôpital Cochin, Paris, France
  9. 9 University of Massachusetts Medical School, Worcester, Massachusetts, USA
  10. 10 Paris-Sud University, Orsay, France
  11. 11 Department of Gastroenterology, Infectious Diseases and Rheumatology, Campus Benjamin Franklin, Charité, Berlin, Germany
  12. 12 Max Planck Institute for Infection Biology, Berlin, Germany
  13. 13 Deutsches Rheumaforschungszentrum, Berlin, Germany
  14. 14 NYU School of Medicine, New York City, New York, USA
  15. 15 National Institutes of Health, Bethesda, Maryland, USA
  16. 16 Leiden University Medical Center, Leiden, Netherlands
  17. 17 University of Erlangen, Erlangen, Germany
  18. 18 Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria
  19. 19 Los Angeles Medical Center, University of California, Los Angeles, California, USA
  20. 20 University of Florence, Florence, Italy
  1. Correspondence to Dr Kevin L Winthrop, Oregon Health and Science University, Portland, OR 97239, USA; winthrop{at}


To develop a comprehensive listing of the greatest unmet scientific and clinical needs in rheumatology. The 20th annual international Targeted Therapies meeting brought more than 100 leading basic scientists and clinical researchers in rheumatology, immunology, epidemiology, molecular biology and other specialties. During the meeting, breakout sessions were convened, consisting of five disease-specific groups with 20–30 experts assigned to each group based on expertise. Specific groups included rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis, systemic lupus erythematosus, connective tissue diseases and a basic science immunology group spanning all of these clinical domains. In each group, experts were asked to consider recent accomplishments within their clinical domain in the last year and update the unmet needs in three categorical areas: basic/translational science, clinical science and therapeutic development, and clinical care. While progress was noted among some of previously identified needs, both new needs were identified and themes from prior meetings were re-iterated: the need for better understanding the heterogeneity within each disease, and for identifying preclinical states of disease allowing treatment and prevention of disease in those at risk, and the elusive ability to cure disease. Within the clinical care realm, improved comorbidity management and patient-centred care continue to be unmet needs, and the need for new and affordable therapeutics was highlighted. Unmet needs for new and accessible targeted therapies, disease prevention and ultimately cure remain a priority in rheumatology.

  • rheumatoid arthritis
  • psoriatic arthritis
  • ankylosing spondylitis
  • spondyloarthritis
  • systemic lupus erythematosus
  • systemic sclerosis
  • sjögren’s syndrome
  • inflammatory myopathies
  • vasculitis

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  • Handling editor Dimitrios T Boumpas

  • Contributors All coauthors contributed to this manuscript’s creation in all aspects including data gathering, analysis, writing and critical revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.