Updated consensus statement on biological agents for the treatment of rheumatic diseases, 2008

The appropriate use of biological agents will require doctors experienced in the diagnosis, treatment and assessment of RA, PsA, AS and other rheumatic diseases who are aware of long-term observations of efficacy and toxicity, including cohort studies and data from registries. Because biological agents have toxicities, patients or their representatives should be provided with information about potential risks and benefits so that they may give informed consent for treatment. While receiving treatment, appropriate vaccination (such as against influenza) should be given when indicated, although the responses have been shown to be suboptimal (category D evidence 246 ). [...]data are available, the use of live attenuated vaccines should only be given before the use of rituximab.