For each new biotherapy, a panel of experts working under the aegis of the CRI (Club Rhumatismes et Inflammation) develops and validates a set of fact sheets.

CRI fact sheets are available for TNF-a antagonists (1), rituximab (2), and abatacept (3).

The new fact sheets presented here are about tocilizumab (RoActemra®), the first interleukin-6 inhibitor. Tocilizumab is indicated in combination with methotrexate in adults with rheumatoid arthritis (RA) who have a history of inadequate effectiveness or intolerance during treatment with one or more disease-modifying antirheumatic drugs (DMARDs) or TNF antagonists. In these patients, tocilizumab can also be used alone when methotrexate is poorly tolerated or when further methotrexate therapy would be inappropriate.

As with previous fact sheets, and thanks to a panel of experts that has continued to expand, we have given pride of place to pragmatism by providing answers to the questions that arise most commonly in everyday practice before, during, and after tocilizumab therapy. To build our fact sheets on a solid foundation, we obtained advice from highly competent endocrinologists, hepatologists, and immunologists. These discussions were fascinating, and we are delighted to be able to share their benefits with you under the form of these fact sheets.

As previously, we have used a colour code to ensure ready differentiation of material supported by evidence from the literature, official recommendations, and expert opinion.

These fact sheets will help us to improve our everyday clinical practice. Further benefits will be obtained from the nationwide registry of patients on tocilizumab (for any reason) set up under the aegis of the CRI and French Society for Rheumatology (SFR). Your contribution to this registry will be invaluable.

Our deepest gratitude goes to the experts who have expended enormous amounts of energy to develop these fact sheets. The fact sheets are published in this special issue of Joint Bone Spine, to whose editorial board we extend our warmest thanks for their close collaboration; and they will be available on the CRI site (http://www.cri-net.com).

Please feel free to send us your comments and requests about these fact sheets. Your input will help to improve future updates.

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 and Jean Sibilia, who were the expert panel coordinators;
and all the experts on the panel.

• Contents

  Rheumatoid Arthritis (RA)

  1. Abstract
     
  2. Initiation of tocilizumab therapy and follow-up
     • Initial pre-treatment workup
     • Monitoring tocilizumab therapy
  3. Diseases: management of patients who have a past or present history of... ?
     • Cardiovascular disease
     • Haematological abnormalities
     • Hepatic abnormalities
     • Bacterial and viral infections
     • Solid cancer or haematological malignancy
     • Ileocolonic disease
     • Infusion-related reactions
  4. Clinical situations: management in the event of...
     • Concomitant medications
     • Surgery or dental care
     • Pregnancy
     • Vaccination
     • Travel

  Diseases other than RA

  1. Using tocilizumab in...
     • Juvenile idiopathic arthritis
     • Castleman’s disease
     • Adult-onset Still’s disease
     • Spondyloarthropathies

Other Documents

1. Acknowledgments/ Conflicts of interest
   
2. References
   
3. Model letters for informing...
   • The office-based rheumatologist
   • The primary-care physician
4. Patient information documents
   
5. Tables

Complete Document

1. Download the complete document

Les membres du comité d'experts du CRI :
Dr Thao Pham (1), Pr Pascal Claudepierre (2), Dr Arnaud Constantin (3), Dr Michel de Bandt (4), Pr Bruno Fautrel (5), Dr Laure Gossec (6), Pr Jacques- Eric Gottenberg (7), Pr Philippe Goupille (8), Dr Séverine Guillaume (9), Pr Eric Hachulla (10), Dr Charles Masson (11), Pr Jacques Morel (12), Dr Xavier Puéchal (13), Pr Alain Saraux (14), Pr Thierry Schaeverbeke (15), Pr Daniel Wendling (16), Pr Eric Bruckert (17), Pr Stanislas Pol (18), Pr Xavier Mariette (19), Pr Jean Sibilia (20) ont perçu des honoraires de l’agence Raison de Santé pour l’élaboration de ces fiches.

(1) Service de Rhumatologie, CHU Conception, Marseille. (2) Service de Rhumatologie, CHU Henri Mondor, Créteil. (3) Service de Rhumatologie, CHU Rangueil, Toulouse. (4) Unité de Rhumatologie, Hôpital Robert Ballanger, Aulnay-sous-Bois. (5) Service de Rhumatologie, CHU Pitié-Salpétrière, Paris. (6) Service de Rhumatologie, CHU Cochin, Paris. (7) Service de Rhumatologie, CHU Hautepierre, Strasbourg . (8) Service de Rhumatologie, CHU Trousseau, Tours. (9) Service de Pédiatrie Générale et Rhumatologie Pédiatrique, CHU Bicêtre, Le Kremlin-Bicêtre. (10) Service de Médecine Interne, CHU Hôpital Claude Huriez, Lille. (11) Service de Rhumatologie, CHU Angers, Angers. (12) Service d’Immuno-Rhumatologie, CHU Lapeyronie, Montpellier. (13) Service de Rhumatologie, CH Le Mans, Le Mans. (14) Service de Rhumatologie, CHU Cavale- Blanche, Brest. (15) Service de Rhumatologie, CHU Pellegrin, Bordeaux. (16) Service de Rhumatologie, CHU Jean Minjoz, Besançon. (17) Service Endocrinologie- Métabolisme, CHU Pitié-Salpétrière, Paris. (18) Unité d’Hépatologie, CHU Cochin, Paris. (19) Service de Rhumatologie, CHU Bicêtre, Le Kremlin-Bicêtre. (20) Service de Rhumatologie, CHU Hautepierre, Strasbourg.