The unmet need in rheumatology: reports from the Targeted Therapies meeting 2016.

The 18th annual international Targeted Therapies meeting brought together over 100 leading scientists and clinicians from around the world in the field of rheumatology. During the meeting, breakout sessions were held consisting of 5 disease-specific groups each with 20-40 experts assigned to each group based on clinical or scientific expertise. Specific groups included: rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis/spondyloarthritis, systemic lupus erythematous, and other connective tissue diseases (e.g. Sjögren's, Behçet's, others). In each group, experts were asked to identify unmet needs in 3 categorical areas: basic/translational science, clinical science and therapeutic development, and clinical care. Needs were prioritised as primary or secondary. Overall, similar primary unmet needs were identified within each disease foci. Within translational science, these included the need for better understanding the heterogeneity within each disease, such that predictive tools for therapeutic response could be developed. Within clinical science and therapeutic trials, the ability to prevent progression to disease onset in those at risk, and the ability to cure disease were identified. A further unmet need was to develop new and accessible therapeutics, as well as to conduct strategic trials of currently approved therapies. Within the clinical care realm, improved co-morbidity management and patient-centered care were identified as unmet needs. Lastly, it was strongly felt there was a need to develop a scientific infrastructure for well-characterised, longitudinal cohorts married with biobanks and mechanisms to support data-sharing. This infrastructure could facilitate many of the unmet needs identified within each disease area.

[1]  C. Salvarani,et al.  Tocilizumab for the treatment of giant cell arteritis , 2018, Expert review of clinical immunology.

[2]  A. Vissink,et al.  The microbiome-systemic diseases connection. , 2016, Oral diseases.

[3]  D. Symmons,et al.  Predictors and outcomes of sustained, intermittent or never achieving remission in patients with recent onset inflammatory polyarthritis: results from the Norfolk Arthritis Register , 2016, Rheumatology.

[4]  S. Yount,et al.  Patient-Reported Outcomes in Systemic Lupus Erythematosus. , 2016, Rheumatic diseases clinics of North America.

[5]  Jinming Li,et al.  Diagnostic Value of Serum IgG4 for IgG4-Related Disease , 2016, Medicine.

[6]  P. Kiely Biologic efficacy optimization--a step towards personalized medicine. , 2016, Rheumatology.

[7]  A. Yoshimura,et al.  Critical Link Between Epigenetics and Transcription Factors in the Induction of Autoimmunity: a Comprehensive Review , 2016, Clinical Reviews in Allergy & Immunology.

[8]  Y. Barenholz,et al.  A liposomal steroid nano-drug for treating systemic lupus erythematosus , 2016, Lupus.

[9]  A. Mahajan,et al.  Clearance Deficiency and Cell Death Pathways: A Model for the Pathogenesis of SLE , 2016, Front. Immunol..

[10]  J. Orazem,et al.  Impact of Out-of-Pocket Costs on Prescription Fills Among New Initiators of Biologic Therapies for Rheumatoid Arthritis , 2016, Journal of managed care & specialty pharmacy.

[11]  H. Ueno,et al.  T follicular helper (Tfh) cells in lupus: Activation and involvement in SLE pathogenesis , 2016, European journal of immunology.

[12]  O. FitzGerald,et al.  Psoriatic arthritis: complexities, comorbidities and implications for the clinic , 2016, Expert review of clinical immunology.

[13]  E. Maverakis,et al.  Interactions of the Immune System with Skin and Bone Tissue in Psoriatic Arthritis: A Comprehensive Review , 2016, Clinical Reviews in Allergy & Immunology.

[14]  M. Marenzana,et al.  Refine, reduce, replace: Imaging of fibrosis and arthritis in animal models. , 2015, Best practice & research. Clinical rheumatology.

[15]  Wei Tang,et al.  Toll-like receptors: potential targets for lupus treatment , 2015, Acta Pharmacologica Sinica.

[16]  C. Ritchlin,et al.  Etiology and Pathogenesis of Psoriatic Arthritis. , 2015, Rheumatic diseases clinics of North America.

[17]  R. Furie,et al.  Lessons Learned From the Clinical Trials of Novel Biologics and Small Molecules in Lupus Nephritis. , 2015, Seminars in nephrology.

[18]  D. D'cruz,et al.  Key issues in the management of patients with systemic lupus erythematosus: latest developments and clinical implications , 2015, Therapeutic advances in musculoskeletal disease.

[19]  Mark Asquith,et al.  The intestinal microbiome in spondyloarthritis , 2015, Current opinion in rheumatology.

[20]  G. Huber,et al.  Morphological and biomechanical analyses of the subchondral mineralized zone in human sacral facet joints: Application to improved diagnosis of osteoarthritis , 2015, Clinical anatomy.

[21]  M. Brown,et al.  The intestinal microbiome in human disease and how it relates to arthritis and spondyloarthritis. , 2015, Best practice & research. Clinical rheumatology.

[22]  Kenneth G. C. Smith,et al.  Emerging concepts in the pathogenesis of antineutrophil cytoplasmic antibody-associated vasculitis , 2015, Current opinion in rheumatology.

[23]  A. Ogdie,et al.  Recognizing and managing comorbidities in psoriatic arthritis , 2015, Current opinion in rheumatology.

[24]  R. Ferriols-Lisart,et al.  Dose modifications of anti-TNF drugs in rheumatoid arthritis patients under real-world settings: a systematic review , 2015, Rheumatology International.

[25]  P. Merkel,et al.  Outcome measures for Takayasu's arteritis , 2015, Current opinion in rheumatology.

[26]  G. Tómasson Outcome measures for antineutrophil cytoplasmic antibody-associated vasculitis , 2015, Current opinion in rheumatology.

[27]  Raveendhara R. Bannuru,et al.  American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis , 2015 .

[28]  A. Armstrong,et al.  Managing Patients with Psoriatic Disease: The Diagnosis and Pharmacologic Treatment of Psoriatic Arthritis in Patients with Psoriasis , 2014, Drugs.

[29]  Désirée van der Heijde,et al.  EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update , 2013, Annals of the rheumatic diseases.

[30]  M. Weisman,et al.  Updated consensus statement on biological agents for the treatment of rheumatic diseases, 2012 , 2013, Annals of the rheumatic diseases.

[31]  D. Isenberg,et al.  B-cell depletion in SLE: clinical and trial experience with rituximab and ocrelizumab and implications for study design , 2013, Arthritis Research & Therapy.

[32]  F. Breedveld,et al.  antirheumatic drugs: 2013 update synthetic and biological disease-modifying management of rheumatoid arthritis with EULAR recommendations for the , 2013 .

[33]  M. Weisman,et al.  Updated consensus statement on biological agents for the treatment of rheumatic diseases, 2010 , 2011, Annals of the rheumatic diseases.

[34]  R. Stasi An overview of pharmacotherapy for anti-neutrophil cytoplasmic antibody-associated vasculitis. , 2010, Drugs of today.

[35]  F. Breedveld,et al.  The PREMIER study: A multicenter, randomized, double-blind clinical trial of combination therapy with adalimumab plus methotrexate versus methotrexate alone or adalimumab alone in patients with early, aggressive rheumatoid arthritis who had not had previous methotrexate treatment. , 2006, Arthritis and rheumatism.

[36]  A. McMahon,et al.  Effect of a treatment strategy of tight control for rheumatoid arthritis (the TICORA study): a single-blind randomised controlled trial , 2004, The Lancet.