EULAR standardised operating procedures for the elaboration, evaluation, dissemination, and implementation of recommendations endorsed by the EULAR standing committees I t is the objective of the EULAR executive committee to promote actions and/or projects aimed at improving the knowledge and/or the recognition of musculoskeletal disorders.The chief aim is to contribute to the improvement of outcome of patients with rheumatic disorders. Apart from the projects devoted to education and research, projects aimed at facilitating the conduct of clinical studies or at improving the management of musculoskeletal disorders are welcome. Such studies can be categorised in four sections:

The use of anti-TNF-alpha therapy (plus lamivudine in the presence of concurrent underlying hepatitis B viral infection) appeared to be safe in that it had no effect on serum aminotransferases and/or viral load. However, repeated monitoring is necessary throughout the treatment period.

To date, there is no evidence that TNF-alpha antagonists are associated with embryo toxicity, teratogenicity or increased pregnancy loss. However, caution should be taken when anti-TNF agents are used during pregnancy, as human experience is still extremely limited, particularly in patients with rheumatic diseases among whom there are several alarming reports. The potential risk should be balanced against the known risks associated with DMARDs and steroid therapy. Large registries will be necessary before firm conclusions can be drawn.

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