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Unmet need in rheumatology: reports from the Targeted Therapies meeting 2018


Winthrop KL1, Weinblatt ME2, Crow MK3, Burmester GR4, Mease PJ5, So AK6, Bykerk V3, Van Vollenhoven RF7, Dougados M8, Kay J9, Mariette X10, Sieper J11, Melchers F12,13, Cronstein BN14, Shevach E15, Breedfeld FC16, Kalden J17, Smolen JS18, Furst DE5,19,20. Ann Rheum Dis. 2019 Feb 2. pii: annrheumdis-2018-214280. doi: 10.1136/annrheumdis-2018-214280. [Epub ahead of print]

Author Information

1 Oregon Health and Science University, Portland, Oregon, USA winthrop@ohsu.edu.

2 Brigham and Women's Hospital, Boston, Massachusetts, USA.

3 Hospital for Special Surgery, New York City, New York, USA.

4 Charité-Universitätsmedizin Berlin, Berlin, Germany.

5 Swedish Medical Center, University of Washington, Seattle, Washington, USA.

6 University of Lausanne, Lausanne, Switzerland.

7 Amsterdam Rheumatology and Immunology Center, Amsterdam, Netherlands.

8 Hôpital Cochin, Paris, France.

9 University of Massachusetts Medical School, Worcester, Massachusetts, USA.

10 Paris-Sud University, Orsay, France.

11 Department of Gastroenterology, Infectious Diseases and Rheumatology, Campus Benjamin Franklin, Charité, Berlin, Germany.

12 Max Planck Institute for Infection Biology, Berlin, Germany.

13 Deutsches Rheumaforschungszentrum, Berlin, Germany.

14 NYU School of Medicine, New York City, New York, USA.

15 Institutes of Health, Bethesda, Maryland, USA.

16 Leiden University Medical Center, Leiden, Netherlands.

17 University of Erlangen, Erlangen, Germany.

18 Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria.

19 Los Angeles Medical Center, University of California, Los Angeles, California, USA.

20 University of Florence, Florence, Italy



To develop a comprehensive listing of the greatest unmet scientific and clinical needs in rheumatology. The 20th annual international Targeted Therapies meeting brought more than 100 leading basic scientists and clinical researchers in rheumatology, immunology, epidemiology, molecular biology and other specialties. During the meeting, breakout sessions were convened, consisting of five disease-specific groups with 20-30 experts assigned to each group based on expertise. Specific groups included rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis, systemic lupus erythematosus, connective tissue diseases and a basic science immunology group spanning all of these clinical domains. In each group, experts were asked to consider recent accomplishments within their clinical domain in the last year and update the unmet needs in three categorical areas: basic/translational science, clinical science and therapeutic development, and clinical care. While progress was noted among some of previously identified needs, both new needs were identified and themes from prior meetings were re-iterated: the need for better understanding the heterogeneity within each disease, and for identifying preclinical states of disease allowing treatment and prevention of disease in those at risk, and the elusive ability to cure disease. Within the clinical care realm, improved comorbidity management and patient-centred care continue to be unmet needs, and the need for new and affordable therapeutics was highlighted. Unmet needs for new and accessible targeted therapies, disease prevention and ultimately cure remain a priority in rheumatology