Updated consensus statement on biological agents for the treatment of rheumatic diseases, 2010

Fürst, Daniel E.; Keystone, Edward; Braun, Jürgen; Breedveld, Ferdinand C.; Gr, Burgio; Benedetti, Fabrizio; Dörner, Thomas; Emery, Paul; Fleischmann, Roy; Gibofsky, Allan; Kalden, Joachim R.; Kavanaugh, Arthur; Kirkham, Bruce; Mease, Philip J.; Sieper, Joachim; Singer, Nora G.; Smolen, JS; Riel, P.L.C.M. van; Weisman, Michael H.; Winthrop, Kevin

doi:10.1136/ard.2010.146852

Cited by 294 publications

(51 citation statements)

References 369 publications

(479 reference statements)

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“…Inclusion criteria for this cohort were RA according to the American College of Rheumatology 1987 criteria,13 age 18 years or older, failure on at least two disease-modifying antirheumatic drugs including methotrexate14 and active disease as measured by the disease activity score in 28 (DAS28) joints of more than 3.2. Patients were treated with either concomitant medication, including methotrexate and prednisone, or etanercept monotherapy.…”

Section: Methodsmentioning

confidence: 99%

Patients non-responding to etanercept obtain lower etanercept concentrations compared with responding patients

et al. 2011

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Section: Methodsmentioning

confidence: 99%

Patients non-responding to etanercept obtain lower etanercept concentrations compared with responding patients

et al. 2011

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“…However, these recommendations, despite their sophisticated and quite comprehensive nature, capture only parts of the complexity of the application of individual drugs. Therefore, consensus statements on the use of groups of agents or individual classes of agents have been developed, providing pertinent information for various stakeholders 15 16. Developing recommendations for individual classes of drugs may bear the value of providing more detailed information on a particular agent than can usually be offered by more general presentations.…”

Section: Scope and Purposementioning

confidence: 99%

Consensus statement on blocking the effects of interleukin-6 and in particular by interleukin-6 receptor inhibition in rheumatoid arthritis and other inflammatory conditions

et al. 2012

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BackgroundSince approval of tocilizumab (TCZ) for treatment of rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA), interleukin 6 (IL-6) pathway inhibition was evaluated in trials of TCZ and other agents targeting the IL-6 receptor and ligand in various RA populations and other inflammatory diseases. This consensus document informs on interference with the IL-6 pathway based on evidence and expert opinion.MethodsPreparation of this document involved international experts in RA treatment and RA patients. A systematic literature search was performed that focused on TCZ and other IL6-pathway inhibitors in RA and other diseases. Subsequently, incorporating available published evidence and expert opinion, the steering committee and a broader expert committee (both including RA patients) formulated the current consensus statement.ResultsThe consensus statement covers use of TCZ as combination- or monotherapy in various RA populations and includes clinical, functional and structural aspects. The statement also addresses the second approved indication in Europe JIA and non-approved indications. Also early phase trials involving additional agents that target the IL-6 receptor or IL-6 were evaluated. Safety concerns, including haematological, hepatic and metabolic issues as well as infections, are addressed likewise.ConclusionsThe consensus statement identifies points to consider when using TCZ, regarding indications, contraindications, screening, dose, comedication, response evaluation and safety. The document is aimed at supporting clinicians and informing patients, administrators and payers on opportunities and limitations of IL-6 pathway inhibition.

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“…29 The European League Against Rheumatism (EULAR) consensus statement notes insufficient data to recommend mandatory screening for tuberculosis before treatment with rituximab but advises against using rituximab in the presence of serious opportunistic infections. 66 However, it recommends rituximab as the first line bDMARD if tuberculosis chemoprophylaxis is contraindicated and for patients from endemic regions. 9 Patients with rheumatoid arthritis should be screened for latent tuberculosis infection according to regional guidelines before starting a bDMARD.…”

Section: Tuberculosismentioning

confidence: 99%

How to use biologic agents in patients with rheumatoid arthritis who have comorbid disease

Richards

Dowell

Quinones

et al. 2015

BMJ

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Although biologic disease modifying anti-rheumatic drugs (bDMARDs) have improved the quality of life of patients with rheumatoid arthritis, side effects remain a problem, especially for patients with pre-existing comorbidities. Randomized controlled trials of such drugs in rheumatoid arthritis typically exclude patients with comorbidities and are of short duration, so they do not provide data on adverse events in these people. Other data sources such as national bDMARD registries are limited by the preselection of patients for both conventional synthetic chemical compound disease modifying anti-rheumatic drugs (csDMARDs) and bDMARDs, and although these databases document comorbidity, they rarely report its severity. This too limits definitive statements on the progression or resolution of pre-existing disease. Although bDMARDs may not be contraindicated in patients with rheumatoid arthritis and certain comorbid diseases, additional assessments or precautions are recommended. This review summarizes current data on the use of bDMARDs in people with rheumatoid arthritis and common comorbid diseases. It provides an evidence base for doctors and their patients when discussing and selecting the appropriate bDMARDs.

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Updated consensus statement on biological agents for the treatment of rheumatic diseases, 2010

Cited by 294 publications

References 369 publications

Patients non-responding to etanercept obtain lower etanercept concentrations compared with responding patients

Patients non-responding to etanercept obtain lower etanercept concentrations compared with responding patients

Consensus statement on blocking the effects of interleukin-6 and in particular by interleukin-6 receptor inhibition in rheumatoid arthritis and other inflammatory conditions

How to use biologic agents in patients with rheumatoid arthritis who have comorbid disease

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