WHO Collaborating Centre consensus meeting on anti-cytokine therapy in rheumatoid arthritis

Severe adult rheumatoid arthritis is a cause of progressive disability and
increased mortality across Europe. A cure for the disease remains elusive, but
control of symptoms and maintenance of individual independence is possible.
Anti-cytokine therapies offer a new approach to disease management. They are
effective after the failure of full doses of methotrexate, and are at least as
effective as methotrexate in retarding the progression of radiological changes.
Until more is known about the long-term safety and efficacy of these drugs they
should be reserved for patients with severe disease who are progressing despite
adequate doses of methotrexate or other disease-modifying anti-rheumatic drugs.
They should be continued until therapeutic failure or intolerance. A
comprehensive health economic evaluation is needed to optimally direct the use of
these drugs. This should be undertaken when long-term safety and efficacy studies
are completed.