Advanced

Is there a role for TNF-alpha antagonists in the treatment of SSc? EUSTAR expert consensus development using the Delphi technique

Distler, J. H. W.; Jordan, S.; Airo, P.; Alegre-Sancho, J. J.; Allanore, Y.; Gurman, A. Balbir; Caporali, R.; Caramaschi, P.; Carreira, P. E. and Chizzolini, C., et al. (2011) In Clinical and Experimental Rheumatology 29(2). p.40-45
Abstract
Objective: To obtain experiences and expert opinion on treatment of SSc patients with TNF-alpha antagonists. Methods: An investigation was carried out among the EUSTAR centres into their expertise on use of TNF-alpha antagonists. Assessment forms on the frequency of TNF-alpha inhibitor use were distributed to EULAR Scleroderma Trials and Research Group (EUSTAR) centres. Afterwards, a three round Delphi exercise was performed to obtain expert consensus on the use of TNF-alpha inhibitors in SSc. Results: Seventy-nine centres returned information on use of TNF-alpha antagonists in SSc patients. A total of 65 patients were treated with TNF-alpha inhibitors in 14 different centres. Forty-eight of the 65 patients treated with TNF-alpha... (More)
Objective: To obtain experiences and expert opinion on treatment of SSc patients with TNF-alpha antagonists. Methods: An investigation was carried out among the EUSTAR centres into their expertise on use of TNF-alpha antagonists. Assessment forms on the frequency of TNF-alpha inhibitor use were distributed to EULAR Scleroderma Trials and Research Group (EUSTAR) centres. Afterwards, a three round Delphi exercise was performed to obtain expert consensus on the use of TNF-alpha inhibitors in SSc. Results: Seventy-nine centres returned information on use of TNF-alpha antagonists in SSc patients. A total of 65 patients were treated with TNF-alpha inhibitors in 14 different centres. Forty-eight of the 65 patients treated with TNF-alpha inhibitors improved. Improvement was mainly seen in patients with arthritis, whereas the effects on fibrosis varied. In the first round of the subsequent Delphi approach, 71 out of 79 experts stated that they would use TNF-alpha antagonists in SSc. Arthritis was suggested as an indication for TNF alpha antagonists by 75% of the experts. However; after the third stage of the Delphi exercise, the acceptance for the off-label use of TNF-alpha antagonists decreased and 59% recommended that TNF-alpha antagonists should not be used or only used in clinical trials in SSc patients, while 38% of the experts suggested the use of TNF-alpha antagonists for arthritis associated with SSc. Conclusions: Most of the experts do not recommend the routine use of TNF-alpha antagonists in systemic sclerosis. Arthritis might be a potential indication in SSc, although controlled clinical trials with TNF-alpha antagonists are needed before general recommendations can be given. (Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
scleroderma, TNF-alpha, fibrosis
in
Clinical and Experimental Rheumatology
volume
29
issue
2
pages
40 - 45
publisher
Pacini
external identifiers
  • wos:000291117200007
ISSN
1593-098X
language
English
LU publication?
yes
id
8cc1db1d-65e5-4e36-ab4d-8f5ed3416b93 (old id 1985540)
date added to LUP
2011-07-01 09:03:36
date last changed
2016-04-15 13:58:42
@article{8cc1db1d-65e5-4e36-ab4d-8f5ed3416b93,
  abstract     = {Objective: To obtain experiences and expert opinion on treatment of SSc patients with TNF-alpha antagonists. Methods: An investigation was carried out among the EUSTAR centres into their expertise on use of TNF-alpha antagonists. Assessment forms on the frequency of TNF-alpha inhibitor use were distributed to EULAR Scleroderma Trials and Research Group (EUSTAR) centres. Afterwards, a three round Delphi exercise was performed to obtain expert consensus on the use of TNF-alpha inhibitors in SSc. Results: Seventy-nine centres returned information on use of TNF-alpha antagonists in SSc patients. A total of 65 patients were treated with TNF-alpha inhibitors in 14 different centres. Forty-eight of the 65 patients treated with TNF-alpha inhibitors improved. Improvement was mainly seen in patients with arthritis, whereas the effects on fibrosis varied. In the first round of the subsequent Delphi approach, 71 out of 79 experts stated that they would use TNF-alpha antagonists in SSc. Arthritis was suggested as an indication for TNF alpha antagonists by 75% of the experts. However; after the third stage of the Delphi exercise, the acceptance for the off-label use of TNF-alpha antagonists decreased and 59% recommended that TNF-alpha antagonists should not be used or only used in clinical trials in SSc patients, while 38% of the experts suggested the use of TNF-alpha antagonists for arthritis associated with SSc. Conclusions: Most of the experts do not recommend the routine use of TNF-alpha antagonists in systemic sclerosis. Arthritis might be a potential indication in SSc, although controlled clinical trials with TNF-alpha antagonists are needed before general recommendations can be given.},
  author       = {Distler, J. H. W. and Jordan, S. and Airo, P. and Alegre-Sancho, J. J. and Allanore, Y. and Gurman, A. Balbir and Caporali, R. and Caramaschi, P. and Carreira, P. E. and Chizzolini, C. and Cutolo, M. and Duruoz, M. Tuncay and Farge-Bancel, D. and Hesselstrand, Roger and Iannone, F. and De Keyser, F. and Kucharz, E. J. and Launay, D. and de la Pena Lefebvre, P. Garcia and Lukacova, O. and Marasini, B. and Martinovic, D. and Marques Neto, J. F. and Radic, M. and Rednic, S. and Riemekasten, G. and Rovensky, J. and Seidel, M. F. and Senel, S. and Smith, V. and Sunderkoetter, C. and Ton, E. and van Laar, J. M. and Matucci-Cerinic, M. and Mueller-Ladner, U. and Distler, O.},
  issn         = {1593-098X},
  keyword      = {scleroderma,TNF-alpha,fibrosis},
  language     = {eng},
  number       = {2},
  pages        = {40--45},
  publisher    = {Pacini},
  series       = {Clinical and Experimental Rheumatology},
  title        = {Is there a role for TNF-alpha antagonists in the treatment of SSc? EUSTAR expert consensus development using the Delphi technique},
  volume       = {29},
  year         = {2011},
}