title: Tocilizumab: therapy and safety management.
abstract: OBJECTIVE
  To develop fact sheets about tocilizumab, in order to assist physicians in the management of patients with inflammatory joint disease.
  
  
  METHODS
  1. selection by a committee of rheumatology experts of the main topics of interest for which fact sheets were desirable; 2. identification and review of publications relevant to each topic; 3. development of fact sheets based on three levels of evidence: evidence-based medicine, official recommendations, and expert opinion. The 20 experts were rheumatologists and invited specialists in other fields, and they had extensive experience with the management of RA. They were members of the CRI (Club Rhumatismes et Inflammation), a section of the Société Francaise de Rhumatologie. Each fact sheet was revised by several. experts and the overall process was coordinated by three experts.
  
  
  RESULTS
  Several topics of major interest were selected: contraindications of tocilizumab; the management of adverse effects and concomitant diseases that may develop during tocilizumab therapy; and the management of everyday situations such as pregnancy, surgery, and immunizations. After a review of the literature and discussions among experts, a consensus was developed about the content of the fact sheets presented here. These fact sheets focus on several points: Several topics of major interest were selected: contraindications of tocilizumab; the management of adverse effects and concomitant diseases that may develop during tocilizumab therapy; and the management of everyday situations such as pregnancy, surgery, and immunizations. After a review of the literature and discussions among experts, a consensus was developed about the content of the fact sheets presented here. These fact sheets focus on several points: 1. in RA, initiation and monitoring of tocilizumab therapy, management of patients with specific past histories, and specific clinical situations such as pregnancy; 2. diseases other than RA, such as juvenile idiopathic arthritis; 3. models of letters for informing the rheumatologist and general practitioner; 4. and patient information.
  
  
  CONCLUSIONS
  These tocilizumab fact sheets built on evidence-based medicine and expert opinion will serve as a practical tool for assisting physicians who manage patients on tocilizumab therapy. They will be available continuously at www.cri-net.com and updated at appropriate intervals.
authors.affiliation: Service de Rhumatologie, CHU Conception, Marseille, France. thao.pham@mail.ap-hm.fr
authors.forename: Thao
authors.initials: T
authors.lastname: Pham
authors.forename: Pascal
authors.initials: P
authors.lastname: Claudepierre
authors.forename: Arnaud
authors.initials: A
authors.lastname: Constantin
authors.forename: Michel
authors.initials: M
authors.lastname: de Bandt
authors.forename: Bruno
authors.initials: B
authors.lastname: Fautrel
authors.forename: Laure
authors.initials: L
authors.lastname: Gossec
authors.forename: Jacques-Eric
authors.initials: JE
authors.lastname: Gottenberg
authors.forename: Philippe
authors.initials: P
authors.lastname: Goupille
authors.forename: Séverine
authors.initials: S
authors.lastname: Guillaume
authors.forename: Eric
authors.initials: E
authors.lastname: Hachulla
authors.forename: Charles
authors.initials: C
authors.lastname: Masson
authors.forename: Jacques
authors.initials: J
authors.lastname: Morel
authors.forename: Xavier
authors.initials: X
authors.lastname: Puéchal
authors.forename: Alain
authors.initials: A
authors.lastname: Saraux
authors.forename: Thierry
authors.initials: T
authors.lastname: Schaeverbeke
authors.forename: Daniel
authors.initials: D
authors.lastname: Wendling
authors.forename: Eric
authors.initials: E
authors.lastname: Bruckert
authors.forename: Stanislas
authors.initials: S
authors.lastname: Pol
authors.forename: Xavier
authors.initials: X
authors.lastname: Mariette
authors.forename: Jean
authors.initials: J
authors.lastname: Sibilia
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D000075202:Contraindications; D019317:Evidence-Based Medicine; D006801:Humans; D010353:Patient Education as Topic; D012307:Risk Factors; D017751:Safety Management
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C502936:tocilizumab