WHO Collaborating Centre consensus meeting on anti-cytokine therapy in rheumatoid arthritis.
Severe adult rheumatoid arthritis is a cause of progressive disability and increased mortality across Europe. A cure for the disease remains elusive, but control of symptoms and maintenance of individual independence is possible. Anti-cytokine therapies offer a new approach to disease management. They are effective after the failure of full doses of methotrexate, and are at least as effective as methotrexate in retarding the progression of radiological changes. Until more is known about the long-term safety and efficacy of these drugs they should be reserved for patients with severe disease who are progressing despite adequate doses of methotrexate or other disease-modifying anti-rheumatic drugs. They should be continued until therapeutic failure or intolerance. A comprehensive health economic evaluation is needed to optimally direct the use of these drugs. This should be undertaken when long-term safety and efficacy studies are completed.
Emery
P
P
University of Leeds, Rheumatology and Rehabilitation Research Unit, 36 Clarendon Road, Leeds LS2 9NZ, UK.
Reginster
J Y
JY
Appelboom
T
T
Breedveld
F C
FC
Edelmann
E
E
Kekow
J
J
Malaise
M
M
Mola
E M
EM
Montecucco
C
C
Sanda
M
M
Sany
J
J
Scott
D L
DL
Serni
U
U
Seydoux
G
G
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D003245:Consensus Statements as Topic; D000075202:Contraindications; D003299:Cooperative Behavior; D016903:Drug Monitoring; D004358:Drug Therapy / Q000592:standards; D004363:Drug Utilization / Q000592:standards; D000068800:Etanercept; D017408:Guidelines as Topic; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D000069285:Infliximab; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014944:World Health Organization
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068800:Etanercept