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Joint Bone Spine
Volume 78, n° S1
pages 15-185 (mai 2011)
Doi : 10.1016/S1297-319X(11)70001-X
TNF alpha antagonist therapy and safety monitoring

Thao Pham 1, , Hervé Bachelez 2, Jean-Marie Berthelot 3, Jacques Blacher 4, Yoram Bouhnik 5, Pascal Claudepierre 6, Arnaud Constantin 7, Bruno Fautrel 8, Philippe Gaudin 9, Vincent Goëb 10, Laure Gossec 11, Philippe Goupille 12, Séverine Guillaume-Czitrom 13, Eric Hachulla 14, Isabelle Huet 15, Denis Jullien 16, Odile Launay 17, Marc Lemann 18, Jean-Francis Maillefert 19, Jean-Pierre Marolleau 20, Valérie Martinez 21, Charles Masson 22, Jacques Morel 23, Luc Mouthon 24, Stanislas Pol 25, Xavier Puéchal 26, Pascal Richette 27, Alain Saraux 28, Thierry Schaeverbeke 29, Martin Soubrier 30, Anne Sudre 9, Tu-Anh Tran 13, Manuelle Viguier 2, Olivier Vittecoq 10, Daniel Wendling 31, Xavier Mariette 32, Jean Sibilia 33
1 Rheumatology Department, CHU Sainte-Marguerite, Marseille 
2 Dermatology Department, CHU Saint-Louis, Paris 
3 Rheumatology Department, CHU Hôtel-Dieu, Nantes 
4 Cardiology Department, CHU Hôtel-Dieu, Paris 
5 Department of Gastroenterology, Chronic IBD, and Nutritional Support, CHU Hôpital Beaujon 
6 Rheumatology Department, CHU Henri Mondor, Créteil 
7 Rheumatology Department, CHU Purpan, Toulouse 
8 Rheumatology Department, CHU Pitié-Salpêtrière, Paris 
9 Rheumatology Department, CHU Grenoble, Grenoble 
10 Rheumatology Department, CHU Bois-Guillaume, Rouen 
11 Rheumatology Department, CHU Cochin, Paris 
12 Rheumatology Department, CHU Trousseau, Tours 
13 Department of Paediatrics and Paediatric Rheumatology, CHU Bicêtre, Le Kremlin-Bicêtre 
14 Internal Medicine Department, CHU Hôpital Claude Huriez, Lille 
15 Pulmonology Department, CHU Pitié-Salpêtrière, Paris 
16 Department of Dermatology and STDs, CHU Edouard Herriot, Lyon 
17 Paris Descartes University, CIC de vaccinologie, Cochin, Pasteur, Paris 
18 Hepatology and Gastroenterology Department, CHU Saint-Louis, Paris 
19 Rheumatology Department, CHU Dijon, Dijon 
20 Haematology Department, CHU Amiens-Picardie, Amiens 
21 Department of Internal Medicine and Clinical Immunology, CHU Hôpital Antoine Béclère, Clamart 
22 Rheumatology Department, CHU Angers, Angers 
23 Immunorheumatology Department, CHU Lapeyronie, Montpellier 
24 Internal Medicine Department, CHU Cochin, Paris 
25 Paris Descartes University – Liver Unit, CHU Cochin, Paris 
26 Rheumatology Department, CH Le Mans, Le Mans 
27 Rheumatology Department, CHU Lariboisière, Paris 
28 Rheumatology Department, CHU Cavale-Blanche, Brest 
29 Rheumatology Department, CHU Pellegrin, Bordeaux 
30 Rheumatology Department, CHU Gabriel-Montpied, Clermont-Ferrand 
31 Rheumatology Department, CHU Jean Minjoz, Besançon 
32 Rheumatology Department, CHU Bicêtre, Le Kremlin-Bicêtre 
33 Rheumatology Department, CHU Hautepierre, Strasbourg 

Corresponding author. Tel.: +33 4 91 38 34 62; fax: +33 4 91 38 38 87.

The authors and coordinators received fees from Raison de Santé for their work on these fact sheets.


To develop and/or update fact sheets about TNF⍺ antagonists treatments, in order to assist physicians in the management of patients with inflammatory joint disease.


selection by a committee of rheumatology experts of the main topics of interest for which fact sheets were desirable;
identification and review of publications relevant to each topic;
development and/or update of fact sheets based on three levels of evidence: evidence-based medicine, official recommendations, and expert opinion. The experts were rheumatologists and invited specialists in other fields, and they had extensive experience with the management of chronic inflammatory diseases, such as rheumatoid. They were members of the CRI (Club Rhumatismes et Inflammation), a section of the Société Francaise de Rhumatologie. Each fact sheet was revised by several experts and the overall process was coordinated by three experts.


Several topics of major interest were selected: contraindications of TNF⍺ antagonists treatments, the management of adverse effects and concomitant diseases that may develop during these therapies, and the management of everyday situations such as pregnancy, surgery, and immunizations. After a review of the literature and discussions among experts, a consensus was developed about the content of the fact sheets presented here. These fact sheets focus on several points:

in RA and SpA, initiation and monitoring of TNF⍺ antagonists treatments, management of patients with specific past histories, and specific clinical situations such as pregnancy;
diseases other than RA, such as juvenile idiopathic arthritis;
models of letters for informing the rheumatologist and general practitioner;
and patient information.


These TNF⍺ antagonists treatments fact sheets built on evidence-based medicine and expert opinion will serve as a practical tool for assisting physicians who manage patients on these therapies. They will be available continuously at and updated at appropriate intervals.

The full text of this article is available in PDF format.

© 2011  Elsevier Masson SAS. All Rights Reserved.
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