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Unmet need in rheumatology: reports from the Targeted Therapies meeting 2019


Winthrop KL1, Weinblatt ME2, Bathon J3, Burmester GR4, Mease PJ5, Crofford L6, Bykerk V7, Dougados M8, Rosenbaum JT9,10, Mariette X11, Sieper J12, Melchers F13, Cronstein BN14, Breedveld FC15, Kalden J16, Smolen JS17, Furst D5,18,19. Ann Rheum Dis. 2019 Oct 29. pii: annrheumdis-2019-216151. doi: 10.1136/annrheumdis-2019-216151. [Epub ahead of print]

Author Information

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

2 Brigham and Womens Hospital, Boston, Massachusetts, USA.

3 Columbia University, College of Physicians & Surgeons, New York City, New York, USA.

4 University Hospital, Berlin, Germany.

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

6 Vanderbilt University, Nashville, Tennessee, USA.

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

8 Hôpital Cochin, Paris, France.

9 Oregon Health Sciences University, Portland, Oregon, USA.

10 Legacy Devers Eye Institute, Portland, Oregon, USA.

11 Paris-Sud University, APHP Université Paris-Saclay, Hôpital Bicêtre, Le Kremlin Bicêtre, France.

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

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

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

15 Leiden University Medical Center, Leiden, The Netherlands.

16 University of Erlangen, Erlangen, Germany.

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

18 University of California, Los Angeles Medical Center, Los Angeles, CA, USA.

19 University of Florence, Florence, Italy.



To detail the greatest areas of unmet scientific and clinical needs in rheumatology.


The 21st annual international Advances in Targeted Therapies meeting brought together 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 5 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 and other systemic autoimmune rheumatic diseases. In each group, experts were asked to identify unmet clinical and translational research needs in general and then to prioritise and detail the most important specific needs within each disease area.


Overarching themes across all disease states included the need to innovate clinical trial design with emphasis on studying patients with refractory disease, the development of trials that take into account disease endotypes and patients with overlapping inflammatory diseases, the need to better understand the prevalence and incidence of inflammatory diseases in developing regions of the world and ultimately to develop therapies that can cure inflammatory autoimmune diseases.


Unmet needs for new therapies and trial designs, particularly for those with treatment refractory disease, remain a top priority in rheumatology.