Rheumatology Advance Access originally published online on January 5, 2005
Rheumatology 2005 44(2):157-163; doi:10.1093/rheumatology/keh464
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Rheumatology Vol. 44 No. 2 © British Society for Rheumatology 2005; all rights reserved
GUIDELINES |
Update on the British Society for Rheumatology guidelines for prescribing TNF
blockers in adults with rheumatoid arthritis (update of previous guidelines of April 2001)
Queen Alexandra Hospital, Portsmouth and 1 Southern Derbyshire Acute Hospitals NHS Trust, UK.
Correspondence to: C. Deighton, Department of Rheumatology, Derbyshire Royal Infirmary, London Road, Derby DE1 2Q4, UK. E-mail: chris.deighton@derbyhospitals.nhs.uk
| The first 150 words of the full text of this article appear below. |
These guidelines have been developed for use by prescribing secondary-care rheumatologists. They are intended to indicate which adult patients with rheumatoid arthritis (RA) may benefit from the anti-tumour necrosis factor (anti-TNF) therapies, precautions that need to be taken in their use and to highlight potential side-effects from these therapies. The previous guidelines applied to the then available anti-TNF therapies (etanercept and infliximab) [1]. These current guidelines would apply to these two products together with adalimumab, which is a newly licensed anti-TNF therapy for RA. This is a rapidly changing field with new data emerging each month, so that it is vital that clinicians keep up to date with this area of practice. These guidelines can only incorporate information that was available to the authors at the time of their completion.
The guidelines have been drawn up by the above working party and have been approved by the British
Eligibility for treatment with biologics therapies
Exclusion criteria
Criteria for withdrawal of therapy
Which anti-TNF therapy should be used?
Should a patient who is failing to respond to one anti-TNF therapy have their treatment changed to an alternative anti-TNF agent?
Can DMARDs other than methotrexate be used in combination with anti-TNF therapies?
Is there a place for alteration in the dose or the frequency of administration of anti-TNF therapy?
Potential adverse effects related to anti-TNF therapy and guidance related to these
1. Serious infections, excluding tuberculosis
Guidelines
2. Tuberculosis
Guidelines
3. Surgical procedures
4. Vaccination
5. Malignancy
Guidelines
6. Systemic lupus erythematosus syndromes and autoimmunity
Guidelines
7. Congestive cardiac failure/cardiovascular disease
Guidelines
8. Demyelination and neurological complications
Guidelines
9. Haematological complications
Guidelines
10. Pregnancy and lactation
Guidelines
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