A series of meetings between a group of experts and hospital or private rheumatologists devoted to the use of TNF-blocking drugs in the treatment of inflammatory rheumatism raised a large number of practical questions.

Under the aegis of the Club Rhumatismes et Inflammation (CRI, Inflammatory Rheumatisms Group of the French Society of Rheumatology, Société française de rhumatologie) and with the institutional support of Wyeth, we decided to provide answers as precise and as relevant as possible to these questions.

These answers are presented in the form of a clinical tool guide which propose management guidelines according to the diseases, symptoms and clinical situations to be managed during introduction or follow-up of anti-TNF therapy. These clinical practice sheets are completed by a pretreatment assessment checklist, and a standard information letter for the patient's attending physician.

We adopted the following methodology to elaborate these forms:

• Identification of all of the questions raised,
• Comprehensive review of the literature for each of these questions,
• Elaboration of a reply weighted according to 3 levels of evidence (evidence-based medicine (EBM), official guidelines and expert opinions), presented in this document by three different colours.
• Review of all of these clinical practice sheets by several experts of the CRI.

We hope that these clinical practice sheets, that can be downloaded from the CRI website and Science Direct (http://www.sciencedirect.com) will rapidly become a useful or even essential tool in your daily practice in order to promote the correct use of anti-TNF medications.

Avec l'aimable concours et l'autorisation de la Revue du Rhumatisme et de sa version en langue anglaise Joint Bone Spine

Xavier MARIETTE, Thao PHAM, Jean SIBILIA

• Complete guide download : CRI's clinical tools - PDF - 569 Ko
  
  
• Chapters download :
  
  Pretreatment workup - PDF - 105 Ko
  
  
  1. Diseases: management of patients who have a past or present history of…
     • Haematological disease other than lymphoma - PDF - 201 Ko
     • Cardiovascular disease (other than congestive heart failure) - PDF - 249 Ko
     • Congestive heart failure - PDF - 124 Ko
     • Bacterial, opportunistic or fungal infections - PDF - 189 Ko
     • Tuberculosis - PDF - 155 Ko
     • Acute or chronic viral infection - PDF - 141 Ko
     • Systemic intolerance and skin reactions - PDF - 109 Ko
     • Lymphoma - PDF - 104 Ko
     • Solid cancer - PDF - 238 Ko
     • Auto-immune disease (e.g., induced lupus or demyelating disease) - PDF - 123 Ko
     • Lung disease such as COPD, bronchiectasis, or interstitial lung disease - PDF - 167 Ko
     • Paradoxical reactions - PDF - 102 Ko
     • Vasculitis - PDF - 114 Ko
  2. Clinical situations: management in the event of...
     1. Concomitant medications - PDF - 140 Ko
     2. Surgery, dental care, burns or injuries - PDF - 156 Ko
     3. Spa therapy - PDF - 109 Ko
     4. Pregnancy - PDF - 142 Ko
     5. Specific situations: dialysis, haemoglobinopathy, splenectomy - PDF - 131 Ko
     6. Elderly patients on TNFα antagonists - PDF - 126 Ko
     7. Vaccination - PDF - 110 Ko
     8. Travel - PDF - 93 Ko
  3. Diseases other than RA
     1. Use of TNFα antagonists in juvenile idiopathic arthritis - PDF - 177 Ko
     2. Use of TNFα antagonists in other conditions - PDF - 151 Ko
        
        
  4. Acknowledgments / Disclosure - PDF - 90 Ko
  5. References - PDF - 316 Ko
  6. APPENDIX 1 : Model Information Letter for the office-based rheumatologist - PDF - 116 Ko
  7. APPENDIX 2 : Model Information Letter for the primary-care physician - PDF - 119 Ko
  8. APPENDIX 3 : Information document for patients with RA - PDF - 127 Ko

The Clinical tool guide was written by:

Pr Pascal CLAUDEPIERRE, Dr Xavier DEPREZ, Pr Philippe GOUPILLE, Dr Pascal HILLIQUIN, DrThao PHAM, Dr Xavier PUÉCHAL, Pr Thierry SCHAEVERBEKE, Pr Jean SIBILIA, under Dr Thao PHAM and Pr Jean SIBILIA coordination.

It was reviewed by the CRI review committee:

Dr Bruno FAUTREL, Pr Xavier MARIETTE, Dr Charles MASSON, Dr Jacques MOREL, Pr Alain SARAUX, under Pr Xavier MARIETTE coordination.

Thao Pham, Hervé Bachelez, Jean-Marie Berthelot, Jacques Blacher, Yoram Bouhnik,
Pascal Claudepierre, Arnaud Constantin, Bruno Fautrel, Philippe Gaudin, Vincent Goëb,
Laure Gossec, Philippe Goupille, Séverine Guillaume-Czitrom, Eric Hachulla, Isabelle
Huet, Denis Jullien, Odile Launay, Marc Lemann
, Jean-Francis Maillefert, Jean-Pierre
Marolleau, Valérie Martinez, Charles Masson, Jacques Morel, Luc Mouthon, Stanislas Pol,
Xavier Puéchal, Pascal Richette, Alain Saraux, Thierry Schaeverbeke, Martin Soubrier,
Anne Sudre, Tu-Anh Tran, Manuelle Viguier, Olivier Vittecoq, Daniel Wendling, Xavier
Mariette, Jean Sibilia.

© Elsevier SAS 2005
Joint Bone Spine Volume 72 supplément 1 page S1-S60 June 2005
publication originale en anglais