Czech Society for Rheumatologyguidelines for biological treatment with TNF blocking agents – supplement of standard treatmentprotocol in rheumatoid arthritis

Overview

In 1999, Czech Society for Rheumatology published standard protocols for the treatment of rheumatoidarthritis (RA), which were modified due to initiation of biological agents in 2002. Extensiveuse of biological agents during the last 2 years increased our knowledge, especially in the preventionof the toxicity of these agents, and compelled another amendment of the standard protocols. Theindications for the treatment of RA with TNF blockers and instructions for their use are reviewed.The safety of anti-TNF therapy with regard to the risk of tuberculosis is discussed. Every patientwith latent tuberculosis has to use preventive antituberculosis treatment 1 month before initiationof TNF blocking agents. The emphasis is put on a need of long term observations of all TNFblockers-treated patients and the use of patients’ registry to reliably evaluate safety and socioeconomicdata of the treatment is recommended.

Key words:
rheumatoid arthritis (RA), TNF blocking agents, standard protocol, tuberculosis