Lessons from a rheumatoid arthritis biologics register

The introduction of anti-tumour necrosis factor (anti-TNF) therapy for the management of rheumatoid arthritis (RA), ankylosing spondylitis, psoriatic arthritis and juvenile idiopathic arthritis has significantly improved the outcome for patients suffering from those severe rheumatic diseases. Similar benefits have also been observed in patients with inflammatory bowel disease, and most recently in patients with psoriasis. However, despite demonstrated safety compared with placebo in early clinical trials in all these conditions, there are still many uncertainties about the long-term safety of these agents, particularly with respect to serious infection and malignancy. There also remains a concern about rare and unexpected adverse events.