Selective Costimulation Modulators: Addressing Unmet Needs in Rheumatoid Arthritis Management

In accordance with ACCME Standards for Commercial Support of Continuing Medical Education and the Health Science Center for Continuing Medical Education Disclosure Policy for CME Activities, faculty members have been asked to disclose any relationship they may have with commercial supporters of this CME activity or with companies providing drugs, medical equipment, etc, that may have relevance to the content of their presentations. Such disclosure is intended to provide participants with sufficient information to evaluate whether any given presentation has been influenced by the faculty's relationship(s) or financial interests with said companies.

The following faculty have reported receiving something of value from the commercial supporter(s) of this activity or from a corporate organization whose product(s) may have relevance to the content of their presentations:

Author(s)

Paul Emery, MA, MD, FRCP

Professor, Academic Section of Musculoskeletal Disease, University of Leeds; Clinical Director, Department of Rheumatology, Leeds Teaching Hospitals NHS Trust, Leeds, England

Disclosures

Disclosure: Paul Emery, MD, MA, has disclosed that he has received an honorarium from the Health Science Center for Continuing Medical Education in conjunction with this supplement. Dr. Emery has also disclosed that he is an investigator and expert speaker for Bristol-Myers Squibb; Consultant: Bristol-Myers Squibb Company; Grants/research support: Bristol-Myers Squibb Company; Honoraria: Bristol-Myers Squibb Company.

John C. Davis, Jr, MD, MPH, FACR, FACP

Assistant Professor of Medicine; Associate Director, Clinical Trials Center; Director, Lupus Clinic, University of California, San Francisco

Disclosures

Disclosure: John C. Davis, Jr., MD, MPH, FACR, FACP, has disclosed that he has received an honorarium from the Health Science Center for Continuing Medical Education in conjunction with this supplement; Consultant: Bristol-Myers Squibb Company; Honoraria: Bristol-Myers Squibb Company.

Lars Klareskog, MD, PhD

Professor; Head, Department of Rheumatology, Department of Medicine, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden

Disclosures

Disclosure: Lars Klareskog, MD, PhD, has disclosed that he has received an honorarium from the Health Science Center for Continuing Medical Education in conjunction with this supplement; Consultant: Abbott Laboratories, AstraZeneca, Bristol-Myers Squibb Company, Celltech, Wyeth; Grants/Research Support: Abbott Laboratories, AstraZeneca, Bristol-Myers Squibb Company, Schering-Plough, Wyeth; Honoraria: Abbott Laboratories, AstraZeneca, Bristol-Myers Squibb Company, Centocor, Wyeth.

Rene R. Westhovens, MD, PhD

Professor, Rheumatology Section, Catholic University of Leuven, Leuven, Belgium; Head, Department of Rheumatology Clinic, University Hospital Leuven, Leuven, Belgium

Disclosures

Disclosure: Rene Westhovens, MD, PhD, has disclosed that he is a consultant for Bristol-Myers Squibb Company and Schering-Plough Belgium. Dr. Westhovens has also disclosed that he has received an honorarium from the Health Science Center for Continuing Medical Education in conjunction with this supplement; Consultant: Bristol-Myers Squibb Company, Novartis, Schering-Plough Belgium; Speaker's Bureau: Bristol-Myers Squibb Company.

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Summary of Clinical Data With TNF-alpha Inhibitors

The currently available biological DMARDs work by targeting downstream inflammatory cytokines, which are produced by a number of immune cells in response to stimulation by CD4+ T cells. Several large, randomized, controlled trials demonstrate that these agents have resulted in significant progress toward the alleviation of symptoms, the slowing of disease progression, and the restoration of function in many patients with RA. Evidence continues to suggest the long-term utility of these agents in both early and longstanding disease, particularly when used in combination with background DMARDs, such as MTX. They are not effective or well tolerated in all patients. Treatment strategies that target earlier steps in the inflammatory cascade may provide valuable alternatives to these therapies.