Table 3

Educational agenda

A.Educational package for patients, developed collaboratively with all stakeholders, particularly patients, caregivers and patient organisations.
B.Educational package for rheumatologists and other health professionals, developed collaboratively with all stakeholders.
C.Educational package for healthcare administrators, policy-makers, funders and governing bodies.
These educational packages could include information about one or more of the following items:
1. TDM
  • What is TDM? What aspects are simple? What aspects are more difficult?

  • What is proactive TDM and what is reactive TDM?

  • What do patients want to know about TDM before incorporating it into their care?

  • Why might it be helpful to perform TDM—in general and in particular circumstances?

  • What is the evidence to support implementation of TDM in rheumatological practice?

  • What are the additional costs of performing TDM versus standard practice?

  • How can TDM be useful for patients and healthcare professionals as part of shared decision making?

2. Biopharmaceuticals
  • What is a biopharmaceutical? (including monoclonal antibodies vs soluble receptor constructs)

  • How is a biopharmaceutical metabolised? Are there differences between monoclonal antibodies and soluble receptor constructs?

  • What is pharmacokinetics and pharmacodynamics and what do we know of this with regard to biopharmaceuticals in inflammatory RMDs?

  • What do we understand about specificity vs selectivity in clinical pharmacology with respect to rheumatology medications, including biopharmaceuticals?

  • How do we measure biopharmaceutical blood concentrations?

3. Immunogenicity
  • What is immunogenicity?

  • What is an ADAb and why do they form?

  • How do we measure ADAbs? (including drug tolerant vs drug sensitive assays)

  • What are the different types of ADAbs (including neutralising, non-neutralising)?

  • How do ADAbs influence biopharmaceutical pharmacokinetics and pharmacodynamics?

  • What are the consequences of ADAb formation? Do ADAbs cause adverse events/side effects? Do they interfere with treatment? What is the frequency of such interefence (sometimes or always)?

  • ADAb, antidrug antibody; RMDs, rheumatic and musculoskeletal diseases; TDM, therapeutic drug monitoring.