The British Society for Rheumatology biologic DMARD safety guidelines in inflammatory arthritis—Executive summary

Abstract

This is the executive summary of The British Society for Rheumatology biologic DMARD safety guidelines in inflammatory arthritis, doi: 10.1093/rheumatology/key208.

The use of biological disease-modifying antirheumatic drugs for inflammatory arthritis in Korea: results of a Korean Expert Consensus

“…Literature search was performed under the following principles: (1) guidelines should be developed by the international network or the national association of rheumatology; (2) guidelines should be published after 2015; and (3) guidelines should be written in English or Korean. Following the review, six guidelines were selected for the management of RA and AS [9,10,12,17,18,25,26]. The Korean guidelines for tuberculosis (TB) and hepatitis B virus (HBV) infection, published by the Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) and the Korean Association for the Study of the Liver, respectively, were also included in the development of the clinical consensus statement [27,28].…”

“…However, there was a dramatic improvement in the lives of many patients with inflammatory arthritis after the introduction of highly effective agents for treatment, i.e., biological disease-modifying antirheumatic drugs (bDMARDs) [7][8][9][10][11][12][13]. Due to their high efficacy, bDMARDs are used increasingly in the treatment of inflammatory arthritis in a recent decade, but the issues regarding appropriate use, safety and cost have been also raised in parallel [14][15][16][17]. The global rheumatology community has realized the importance of these issues regarding bDMARDs use, facilitating the development of several recommendations and guidelines from the major rheumatology societies including the American College of Rheumatology (ACR) [9,10], the European League Against Rheumatism (EULAR)…”

Biologic treatments for rheumatoid arthritis

“…Some agents have specific toxicities and monitoring requirements fully explained in the product characteristics, with guidelines on how to manage these recently updated for csDMARDs 28 and bDMARDs. 29 Whereas guidelines indicate that bDMARDs/tsDMARDs should be prescribed in a T2T model of care in all patients failing to achieve low disease activity or remission with csDMARDs, 2,3 in some countries, including England and Wales, an additional threshold of having a high DAS28 score of at least 5.1 is required. This is contentious as it denies access to bDMARDs/tsDMARDs for a group of patients with moderate DAS28 scores.…”

Impact of Rheumatoid Arthritis and Its Management on Falls, Fracture and Bone Mineral Density in UK Biobank

“…Biologic agents used in the treatment of RA may have a beneficial effect on bone as we know that pro-inflammatory cytokines such as TNF-α, IL-1, and IL-6 play an important role in bone resorption (17,18). Common biologic agents used in the treatment of RA include: anti-TNF agents such as Adalimumab, Ertanacept, and Infliximab; Rituximab which targets CD20 on B-cells; Tocilizumab which targets the Anti-IL-6 receptor and more recently janus kinase (JAK) inhibitors such as Baricitinib and Tofacitinib (19).…”