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Joint Bone Spine
Volume 80, n° 6
pages 574-581 (décembre 2013)
Doi : 10.1016/j.jbspin.2013.09.001
accepted : 6 August 2013
Recommendations for using TNFα antagonists and French Clinical Practice Guidelines endorsed by the French National Authority for Health

Vincent Goëb a, , Marc Ardizzone b, Laurent Arnaud c, Jérôme Avouac d, Athan Baillet e, Alexandre Belot f, Béatrice Bouvard g, Pascal Coquerelle h, Sabrina Dadoun i, Alain Diguet j, David Launay k, Danielle Lebouc l, 1, Pierre Loulergue m, Sophie Mahy n, Pascal Mestat o, Gaël Mouterde p, Benjamin Terrier q, Coralie Varoquier r, Mathieu Verdet s, Xavier Puéchal t, Jean Sibilia u
on behalf of the

Club Rhumatismes et Inflammations (CRI)

a Service de Rhumatologie, CHU d’Amiens et EA 4666, Faculté de Médecine, Université Picardie-Jules-Verne, Amiens, France 
b Service de Rhumatologie, CH de Mulhouse, 68100 Mulhouse, France 
c Service de Médecine Interne, La Pitié Salpêtrière, AP–HP, 75013 Paris, France 
d Service de Rhumatologie A, Hôpital Cochin, Inserm U1016, Institut Cochin, 75014 Paris, France 
e Service de Rhumatologie, Hôpital Sud, GREPI, AGIM, UJF-CNRS FRE3405, 38434 Echirolles, France 
f Service de Néphrologie et Rhumatologie pédiatriques, Hôpital Femme-Mère–Enfant, Hospices Civils de Lyon, Bron, Unité Inserm U851, 69677 Lyon, France 
g Service de Rhumatologie, CHU d’Angers, 49100 Angers, France 
h Service de Néphrologie-Rhumatologie, Centre Hospitalier de Béthune, 62660 Beuvry, France 
i Service de Rhumatologie, La Pitié Salpêtrière, AP–HP, 75013 Paris, France 
j Service de Gynécologie–Obstétrique, CHU, Hôpitaux de Rouen, 76034 Rouen, France 
k Service de Médecine Interne, Hôpital Claude-Huriez, CHRU de Lille, EA 2686, Faculté de Médecine, Pôle Recherche, Laboratoire d’Immunologie, 59000 Lille, France 
l 49000 Angers, France 
m Service de Maladies Infectieuses, Hôpital Cochin, AP–HP, 75014 Paris, France 
n Service de Maladies Infectieuses, CHU de Dijon, 21079 Dijon, France 
o Maison médicale, médecine générale, 78800 Houilles, France 
p Département de Rhumatologie, Hôpital Lapeyronie, CHU de Montpellier, 34295 Montpellier, France 
q Médecine Interne, Hôpital Cochin, AP–HP, 75014 Paris, France 
r Rhumatologie, Polyclinique Saint-André, 51100 Reims, France 
s Service de Rhumatologie, CH d’Elbeuf, 76503 Elbeuf, France 
t Service de Médecine Interne, Hôpital Cochin, AP–HP, Paris, France 
u Service de Rhumatologie, CHRU de Strasbourg, 67000 Strasbourg, France 

Corresponding author.

The use of TNFα antagonists must follow specific guidelines to ensure optimal effectiveness and safety. The French Society for Rheumatology (SFR) and Task Force on Inflammatory Joint Diseases (CRI), in partnership with several French learned societies, asked the French National Authority for Health (HAS) to develop and endorse good practice guidelines for the prescription and monitoring of TNFα antagonist therapy by physicians belonging to various specialties. These guidelines were developed, then, validated by two multidisciplinary panels of experts based on an exhaustive review of the recent literature and in compliance with the methodological rules set forth by the HAS. They pertain to the initial prescription of TNFα antagonists and to a variety of clinical situations that can arise during the follow-up of patients receiving TNFα antagonists (infections, malignancies, pregnancy, vaccination, paradoxical adverse events, surgery, use in older patients, and vasculitides).

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

Keywords : TNFα antagonist, Etanercept, Adalimumab, Infliximab, Golimumab, Certolizumab, Cancer, Infection, Vaccination, Pregnancy, Older patients, Surgery, Vasculitis, Paradoxical adverse events, Recommendations, French National Authority for Health (HAS)

 The Good Practice Guidelines reported herein have been endorsed by the French National Authority for Health (Haute autorité de santé française , HAS). This endorsement means that the Good Practice Guidelines were developed in compliance with the procedures and methodological rules recommended by the HAS. Any challenges to the contents of the guidelines should be directed to the promoter of this work, that is, the French Society for Rheumatology (Société française de rhumatologie , SFR).

1  Patient.
2  Occult hepatitis B is defined as negative HBsAg, positive anti-HBc, negative anti-HBs, and detectable HBV-DNA.

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