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Significant progress has been acquired in the treatment of
rheumatic conditions with the introduction of biologic therapies,
which has enabled better control of disease activity and improved
patients long-term outcome. Apart from several biologic treatments
already licensed for use in autoimmune rheumatic conditions,
numerous other agents are currently under investigation. This rapid
expansion of the therapeutic armamentarium requires a critical
analysis of individual biologic options and their clinical
indications, in order to facilitate the optimal use of these new
therapies. The authors felt that a comprehensive book revisiting
all the evidence available regarding the efficacy,
cost-effectiveness and health implications of the use of biologics
in rheumatology was needed in order to integrate the clinical,
ethical and socio-economic aspects related to their use. This book
is aimed at specialist doctors, trainees, nurses and health
professionals working in the field of rheumatology. It critically
appraises the level of evidence behind the use of biologic agents
in diverse autoimmune diseases, comprising separate chapters which
focus on rheumatoid arthritis, systemic lupus erythematosus,
myositis, systemic sclerosis, Sjogrens syndrome, seronegative
spondyloarthropathies, psoriatic arthritis and psoriasis, small,
medium and large vessel vasculitis, osteoporosis, and interstitial
lung disease associated with rheumatic conditions. In addition, the
book explores aspects related to the use of biologic agents, such
as ethical considerations of consenting patients to take part in
clinical trials with biologics, and adolescent and adult
rheumatology nurse perspectives related to patients benefits of
biologic therapies. Particular interest is given to the use of
biologics during pregnancy and assessment of their infectious
risks. A separate chapter explores the off-target benefits
associated with the use of anti-TNF therapies. Several chapters
include data about cost-effectiveness, and national and
international guidelines for the use of biologic agents in
different rheumatic conditions.
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