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Consensus statement on blocking the effects of interleukin-6 and in particular by interleukin-6 receptor inhibition in rheumatoid arthritis and other inflammatory conditions

Identifieur interne : 004902 ( Main/Exploration ); précédent : 004901; suivant : 004903

Consensus statement on blocking the effects of interleukin-6 and in particular by interleukin-6 receptor inhibition in rheumatoid arthritis and other inflammatory conditions

Auteurs : Josef S. Smolen [Autriche] ; Monika M. Schoels [Autriche] ; Norihiro Nishimoto [Japon] ; Ferdinand C. Breedveld [Pays-Bas] ; Gerd R. Burmester [Allemagne] ; Maxime Dougados [France] ; Paul Emery [Royaume-Uni] ; Gianfranco Ferraccioli [Italie] ; Cem Gabay [Suisse] ; Allan Gibofsky [États-Unis] ; Juan Jesus Gomez-Reino [Espagne] ; Graeme Jones [Australie] ; Tore K. Kvien [Norvège] ; Miho Murakami [Japon] ; Neil Betteridge [Royaume-Uni] ; Clifton O. Bingham [États-Unis] ; Vivian Bykerk [Suisse] ; Ernest H. Choy [Royaume-Uni] ; Bernard Combe [France] ; Maurizio Cutolo [Italie] ; Winfried Graninger [Autriche] ; Angel Lanas [Espagne] ; Emilio Martin-Mola [Espagne] ; Carlomaurizio Montecucco [Italie] ; Mikkel Ostergaard [Danemark] ; Karel Pavelka [République tchèque] ; Andrea Rubbert-Roth [Allemagne] ; Naveed Sattar [Royaume-Uni] ; Marieke Scholte-Voshaar [Suisse] ; Yoshiya Tanaka [Japon] ; Michael Trauner [Autriche] ; Gabriele Valentini [Italie] ; Kevin L. Winthrop [États-Unis] ; Maarten De Wit [Pays-Bas] ; Désirée Van Der Heijde [Pays-Bas]

Source :

RBID : ISTEX:B7684EF8379AD6695DCF92C88BB2940E8C72BDC5

English descriptors

Abstract

Background Since approval of tocilizumab (TCZ) for treatment of rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA), interleukin 6 (IL-6) pathway inhibition was evaluated in trials of TCZ and other agents targeting the IL-6 receptor and ligand in various RA populations and other inflammatory diseases. This consensus document informs on interference with the IL-6 pathway based on evidence and expert opinion. Methods Preparation of this document involved international experts in RA treatment and RA patients. A systematic literature search was performed that focused on TCZ and other IL6-pathway inhibitors in RA and other diseases. Subsequently, incorporating available published evidence and expert opinion, the steering committee and a broader expert committee (both including RA patients) formulated the current consensus statement. Results The consensus statement covers use of TCZ as combination- or monotherapy in various RA populations and includes clinical, functional and structural aspects. The statement also addresses the second approved indication in Europe JIA and non-approved indications. Also early phase trials involving additional agents that target the IL-6 receptor or IL-6 were evaluated. Safety concerns, including haematological, hepatic and metabolic issues as well as infections, are addressed likewise. Conclusions The consensus statement identifies points to consider when using TCZ, regarding indications, contraindications, screening, dose, comedication, response evaluation and safety. The document is aimed at supporting clinicians and informing patients, administrators and payers on opportunities and limitations of IL-6 pathway inhibition.

Url:
DOI: 10.1136/annrheumdis-2012-202469


Affiliations:


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Le document en format XML

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<country xml:lang="fr">Italie</country>
<wicri:regionArea>Division of Rheumatology, Policlinico S. Matteo, University of Pavia, Pavia</wicri:regionArea>
<wicri:noRegion>Pavia</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Ostergaard, Mikkel" sort="Ostergaard, Mikkel" uniqKey="Ostergaard M" first="Mikkel" last="Ostergaard">Mikkel Ostergaard</name>
<affiliation wicri:level="3">
<country xml:lang="fr">Danemark</country>
<wicri:regionArea>Department of Rheumatology, Copenhagen University Hospital at Glostrup, Copenhagen</wicri:regionArea>
<placeName>
<settlement type="city">Copenhague</settlement>
<region type="région" nuts="2">Hovedstaden</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Pavelka, Karel" sort="Pavelka, Karel" uniqKey="Pavelka K" first="Karel" last="Pavelka">Karel Pavelka</name>
<affiliation wicri:level="3">
<country xml:lang="fr">République tchèque</country>
<wicri:regionArea>Institute of Rheumatology and Clinics of Rheumatology, Charles University, Prague</wicri:regionArea>
<placeName>
<settlement type="city">Prague</settlement>
<region type="région" nuts="2">Bohême centrale</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Rubbert Roth, Andrea" sort="Rubbert Roth, Andrea" uniqKey="Rubbert Roth A" first="Andrea" last="Rubbert-Roth">Andrea Rubbert-Roth</name>
<affiliation wicri:level="1">
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Internal Medicine I, University of Cologne, Cologne</wicri:regionArea>
<wicri:noRegion>Cologne</wicri:noRegion>
<wicri:noRegion>Cologne</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Sattar, Naveed" sort="Sattar, Naveed" uniqKey="Sattar N" first="Naveed" last="Sattar">Naveed Sattar</name>
<affiliation wicri:level="4">
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Glasgow Cardiovascular Research Center, University of Glasgow, Glasgow</wicri:regionArea>
<orgName type="university">Université de Glasgow</orgName>
<placeName>
<settlement type="city">Glasgow</settlement>
<region type="country">Écosse</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Scholte Voshaar, Marieke" sort="Scholte Voshaar, Marieke" uniqKey="Scholte Voshaar M" first="Marieke" last="Scholte-Voshaar">Marieke Scholte-Voshaar</name>
<affiliation wicri:level="1">
<country xml:lang="fr">Suisse</country>
<wicri:regionArea>EULAR Standing Committee of People with Arthritis/Rheumatism in Europe, Zurich</wicri:regionArea>
<wicri:noRegion>Zurich</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Tanaka, Yoshiya" sort="Tanaka, Yoshiya" uniqKey="Tanaka Y" first="Yoshiya" last="Tanaka">Yoshiya Tanaka</name>
<affiliation wicri:level="1">
<country xml:lang="fr">Japon</country>
<wicri:regionArea>1st Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu</wicri:regionArea>
<wicri:noRegion>Kitakyushu</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Trauner, Michael" sort="Trauner, Michael" uniqKey="Trauner M" first="Michael" last="Trauner">Michael Trauner</name>
<affiliation wicri:level="3">
<country xml:lang="fr">Autriche</country>
<wicri:regionArea>Division of Gastroenterology and Hepatology, Department of Medicine 3, Medical University of Vienna, Vienna</wicri:regionArea>
<placeName>
<settlement type="city">Vienne (Autriche)</settlement>
<region nuts="2" type="province">Vienne (Autriche)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Valentini, Gabriele" sort="Valentini, Gabriele" uniqKey="Valentini G" first="Gabriele" last="Valentini">Gabriele Valentini</name>
<affiliation wicri:level="1">
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Internal Medicine, University of Naples, Rheumatology Unit, Naples</wicri:regionArea>
<wicri:noRegion>Naples</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Winthrop, Kevin L" sort="Winthrop, Kevin L" uniqKey="Winthrop K" first="Kevin L" last="Winthrop">Kevin L. Winthrop</name>
<affiliation wicri:level="2">
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Infectious Diseases, Oregon Health and Science University, Portland, Oregon</wicri:regionArea>
<placeName>
<region type="state">Oregon</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="De Wit, Maarten" sort="De Wit, Maarten" uniqKey="De Wit M" first="Maarten" last="De Wit">Maarten De Wit</name>
<affiliation wicri:level="3">
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department Medical Humanities, VU Medical Centre, Amsterdam</wicri:regionArea>
<placeName>
<settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Van Der Heijde, Desiree" sort="Van Der Heijde, Desiree" uniqKey="Van Der Heijde D" first="Désirée" last="Van Der Heijde">Désirée Van Der Heijde</name>
<affiliation wicri:level="3">
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Rheumatology, Leiden University Medical Center, Leiden</wicri:regionArea>
<placeName>
<settlement type="city">Leyde</settlement>
<region nuts="2" type="province">Hollande-Méridionale</region>
</placeName>
</affiliation>
</author>
</analytic>
<monogr></monogr>
<series>
<title level="j">Annals of the Rheumatic Diseases</title>
<title level="j" type="abbrev">Ann Rheum Dis</title>
<idno type="ISSN">0003-4967</idno>
<idno type="eISSN">1468-2060</idno>
<imprint>
<publisher>BMJ Publishing Group Ltd and European League Against Rheumatism</publisher>
<date type="published" when="2013-04">2013-04</date>
<biblScope unit="volume">72</biblScope>
<biblScope unit="issue">4</biblScope>
<biblScope unit="page" from="482">482</biblScope>
</imprint>
<idno type="ISSN">0003-4967</idno>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt>
<idno type="ISSN">0003-4967</idno>
</seriesStmt>
</fileDesc>
<profileDesc>
<textClass>
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<term>Abatacept</term>
<term>Active disease</term>
<term>Adacta trial</term>
<term>Adalimumab</term>
<term>Adalimumab monotherapy</term>
<term>Adult onset disease</term>
<term>Adult patients</term>
<term>Adverse event</term>
<term>Adverse events</term>
<term>Advisory board meetings</term>
<term>Advisory boards</term>
<term>Aletaha</term>
<term>American college</term>
<term>Anaphylactic reactions</term>
<term>Ankylosing spondylitis</term>
<term>Antirheumatic</term>
<term>Antirheumatic drugs</term>
<term>Antiviral agents</term>
<term>Arthritis</term>
<term>Arthritis care</term>
<term>Arthritis rheum</term>
<term>Available data</term>
<term>Axial spondyloarthritis</term>
<term>Baseline</term>
<term>Biologic agents</term>
<term>Biological agents</term>
<term>Biological antirheumatic drugs</term>
<term>Cardiovascular risk</term>
<term>Chronic hepatitis</term>
<term>Clin</term>
<term>Clinical disease activity index</term>
<term>Clinical immunology</term>
<term>Clinical practice</term>
<term>Clinical remission</term>
<term>Clinical superiority</term>
<term>Clinical trial</term>
<term>Clinical trial data</term>
<term>Clinical trials</term>
<term>Combination therapy</term>
<term>Composite measure</term>
<term>Consensus</term>
<term>Consensus statement</term>
<term>Consensus statement table</term>
<term>Consensus statements</term>
<term>Consulting fees research grants</term>
<term>Disease activity</term>
<term>Disease activity score</term>
<term>Dmards</term>
<term>Dose escalation</term>
<term>Dose increase</term>
<term>Eular</term>
<term>Eular recommendations</term>
<term>Expert advice</term>
<term>Expert opinion</term>
<term>Gastrointestinal perforations</term>
<term>Giant cell arteritis</term>
<term>Glucocorticoid therapy</term>
<term>Grant support</term>
<term>Health professionals</term>
<term>Hepatitis</term>
<term>Higher dose</term>
<term>Human receptor</term>
<term>Humanized receptor antibody</term>
<term>Inadequate response</term>
<term>Inadequate responses</term>
<term>Individual classes</term>
<term>Infusion</term>
<term>Inhibition</term>
<term>Inhibitor</term>
<term>Internal medicine</term>
<term>International study</term>
<term>Intravenous infusion</term>
<term>Joint counts</term>
<term>Joint damage</term>
<term>Juvenile idiopathic arthritis</term>
<term>Latent tuberculosis</term>
<term>Lower dose</term>
<term>Medical university</term>
<term>Methotrexate</term>
<term>Monoclonal antibody</term>
<term>Monotherapy</term>
<term>More information</term>
<term>Multicentric castleman disease</term>
<term>Nishimoto</term>
<term>Online</term>
<term>Online supplement</term>
<term>Other biologicals</term>
<term>Other compounds</term>
<term>Other diseases</term>
<term>Other dmards</term>
<term>Other indications</term>
<term>Other inhibitors</term>
<term>Other sdmards</term>
<term>Pathway</term>
<term>Pathway inhibition</term>
<term>Perforation</term>
<term>Polymyalgia rheumatica</term>
<term>Possible contraindications</term>
<term>Psoriatic arthritis</term>
<term>Randomised</term>
<term>Randomized</term>
<term>Receptor</term>
<term>Receptor antibody</term>
<term>Receptor inhibition</term>
<term>Remission</term>
<term>Research grants</term>
<term>Response rates</term>
<term>Rheum</term>
<term>Rheumatic disease</term>
<term>Rheumatic diseases</term>
<term>Rheumatoid</term>
<term>Rheumatoid arthritis</term>
<term>Rheumatoid arthritis patients</term>
<term>Rheumatol</term>
<term>Rheumatology</term>
<term>Risk factors</term>
<term>Rituximab</term>
<term>Roche</term>
<term>Safety aspects</term>
<term>Sdmards</term>
<term>Serious infections</term>
<term>Several case reports</term>
<term>Significant differences</term>
<term>Smolen</term>
<term>Synthetic disease</term>
<term>Systematic literature review</term>
<term>Systematic review</term>
<term>Systemic lupus erythematosus</term>
<term>Systemic sclerosis</term>
<term>Task force</term>
<term>Therapy</term>
<term>Tocilizumab</term>
<term>Tocilizumab monotherapy</term>
<term>Treatment option</term>
<term>Treatment target</term>
<term>Tumor necrosis factor</term>
<term>Tumour necrosis factor</term>
<term>Virus infection</term>
<term>Washout period</term>
</keywords>
<keywords scheme="Teeft" xml:lang="en">
<term>Abatacept</term>
<term>Active disease</term>
<term>Adacta trial</term>
<term>Adalimumab</term>
<term>Adalimumab monotherapy</term>
<term>Adult onset disease</term>
<term>Adult patients</term>
<term>Adverse event</term>
<term>Adverse events</term>
<term>Advisory board meetings</term>
<term>Advisory boards</term>
<term>Aletaha</term>
<term>American college</term>
<term>Anaphylactic reactions</term>
<term>Ankylosing spondylitis</term>
<term>Antirheumatic</term>
<term>Antirheumatic drugs</term>
<term>Antiviral agents</term>
<term>Arthritis</term>
<term>Arthritis care</term>
<term>Arthritis rheum</term>
<term>Available data</term>
<term>Axial spondyloarthritis</term>
<term>Baseline</term>
<term>Biologic agents</term>
<term>Biological agents</term>
<term>Biological antirheumatic drugs</term>
<term>Cardiovascular risk</term>
<term>Chronic hepatitis</term>
<term>Clin</term>
<term>Clinical disease activity index</term>
<term>Clinical immunology</term>
<term>Clinical practice</term>
<term>Clinical remission</term>
<term>Clinical superiority</term>
<term>Clinical trial</term>
<term>Clinical trial data</term>
<term>Clinical trials</term>
<term>Combination therapy</term>
<term>Composite measure</term>
<term>Consensus</term>
<term>Consensus statement</term>
<term>Consensus statement table</term>
<term>Consensus statements</term>
<term>Consulting fees research grants</term>
<term>Disease activity</term>
<term>Disease activity score</term>
<term>Dmards</term>
<term>Dose escalation</term>
<term>Dose increase</term>
<term>Eular</term>
<term>Eular recommendations</term>
<term>Expert advice</term>
<term>Expert opinion</term>
<term>Gastrointestinal perforations</term>
<term>Giant cell arteritis</term>
<term>Glucocorticoid therapy</term>
<term>Grant support</term>
<term>Health professionals</term>
<term>Hepatitis</term>
<term>Higher dose</term>
<term>Human receptor</term>
<term>Humanized receptor antibody</term>
<term>Inadequate response</term>
<term>Inadequate responses</term>
<term>Individual classes</term>
<term>Infusion</term>
<term>Inhibition</term>
<term>Inhibitor</term>
<term>Internal medicine</term>
<term>International study</term>
<term>Intravenous infusion</term>
<term>Joint counts</term>
<term>Joint damage</term>
<term>Juvenile idiopathic arthritis</term>
<term>Latent tuberculosis</term>
<term>Lower dose</term>
<term>Medical university</term>
<term>Methotrexate</term>
<term>Monoclonal antibody</term>
<term>Monotherapy</term>
<term>More information</term>
<term>Multicentric castleman disease</term>
<term>Nishimoto</term>
<term>Online</term>
<term>Online supplement</term>
<term>Other biologicals</term>
<term>Other compounds</term>
<term>Other diseases</term>
<term>Other dmards</term>
<term>Other indications</term>
<term>Other inhibitors</term>
<term>Other sdmards</term>
<term>Pathway</term>
<term>Pathway inhibition</term>
<term>Perforation</term>
<term>Polymyalgia rheumatica</term>
<term>Possible contraindications</term>
<term>Psoriatic arthritis</term>
<term>Randomised</term>
<term>Randomized</term>
<term>Receptor</term>
<term>Receptor antibody</term>
<term>Receptor inhibition</term>
<term>Remission</term>
<term>Research grants</term>
<term>Response rates</term>
<term>Rheum</term>
<term>Rheumatic disease</term>
<term>Rheumatic diseases</term>
<term>Rheumatoid</term>
<term>Rheumatoid arthritis</term>
<term>Rheumatoid arthritis patients</term>
<term>Rheumatol</term>
<term>Rheumatology</term>
<term>Risk factors</term>
<term>Rituximab</term>
<term>Roche</term>
<term>Safety aspects</term>
<term>Sdmards</term>
<term>Serious infections</term>
<term>Several case reports</term>
<term>Significant differences</term>
<term>Smolen</term>
<term>Synthetic disease</term>
<term>Systematic literature review</term>
<term>Systematic review</term>
<term>Systemic lupus erythematosus</term>
<term>Systemic sclerosis</term>
<term>Task force</term>
<term>Therapy</term>
<term>Tocilizumab</term>
<term>Tocilizumab monotherapy</term>
<term>Treatment option</term>
<term>Treatment target</term>
<term>Tumor necrosis factor</term>
<term>Tumour necrosis factor</term>
<term>Virus infection</term>
<term>Washout period</term>
</keywords>
</textClass>
<langUsage>
<language ident="en">en</language>
</langUsage>
</profileDesc>
</teiHeader>
<front>
<div type="abstract">Background Since approval of tocilizumab (TCZ) for treatment of rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA), interleukin 6 (IL-6) pathway inhibition was evaluated in trials of TCZ and other agents targeting the IL-6 receptor and ligand in various RA populations and other inflammatory diseases. This consensus document informs on interference with the IL-6 pathway based on evidence and expert opinion. Methods Preparation of this document involved international experts in RA treatment and RA patients. A systematic literature search was performed that focused on TCZ and other IL6-pathway inhibitors in RA and other diseases. Subsequently, incorporating available published evidence and expert opinion, the steering committee and a broader expert committee (both including RA patients) formulated the current consensus statement. Results The consensus statement covers use of TCZ as combination- or monotherapy in various RA populations and includes clinical, functional and structural aspects. The statement also addresses the second approved indication in Europe JIA and non-approved indications. Also early phase trials involving additional agents that target the IL-6 receptor or IL-6 were evaluated. Safety concerns, including haematological, hepatic and metabolic issues as well as infections, are addressed likewise. Conclusions The consensus statement identifies points to consider when using TCZ, regarding indications, contraindications, screening, dose, comedication, response evaluation and safety. The document is aimed at supporting clinicians and informing patients, administrators and payers on opportunities and limitations of IL-6 pathway inhibition.</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>Allemagne</li>
<li>Australie</li>
<li>Autriche</li>
<li>Danemark</li>
<li>Espagne</li>
<li>France</li>
<li>Italie</li>
<li>Japon</li>
<li>Norvège</li>
<li>Pays-Bas</li>
<li>Royaume-Uni</li>
<li>République tchèque</li>
<li>Suisse</li>
<li>États-Unis</li>
</country>
<region>
<li>Angleterre</li>
<li>Berlin</li>
<li>Bohême centrale</li>
<li>Communauté de Madrid</li>
<li>Grand Londres</li>
<li>Hollande-Méridionale</li>
<li>Hollande-Septentrionale</li>
<li>Hovedstaden</li>
<li>Languedoc-Roussillon</li>
<li>Latium</li>
<li>Maryland</li>
<li>Occitanie (région administrative)</li>
<li>Oregon</li>
<li>Vienne (Autriche)</li>
<li>Écosse</li>
<li>État de New York</li>
<li>Île-de-France</li>
<li>Østlandet</li>
</region>
<settlement>
<li>Amsterdam</li>
<li>Berlin</li>
<li>Copenhague</li>
<li>Glasgow</li>
<li>Leyde</li>
<li>Londres</li>
<li>Madrid</li>
<li>Montpellier</li>
<li>Oslo</li>
<li>Paris</li>
<li>Prague</li>
<li>Rome</li>
<li>Vienne (Autriche)</li>
</settlement>
<orgName>
<li>Université de Glasgow</li>
</orgName>
</list>
<tree>
<country name="Autriche">
<region name="Vienne (Autriche)">
<name sortKey="Smolen, Josef S" sort="Smolen, Josef S" uniqKey="Smolen J" first="Josef S" last="Smolen">Josef S. Smolen</name>
</region>
<name sortKey="Graninger, Winfried" sort="Graninger, Winfried" uniqKey="Graninger W" first="Winfried" last="Graninger">Winfried Graninger</name>
<name sortKey="Schoels, Monika M" sort="Schoels, Monika M" uniqKey="Schoels M" first="Monika M" last="Schoels">Monika M. Schoels</name>
<name sortKey="Smolen, Josef S" sort="Smolen, Josef S" uniqKey="Smolen J" first="Josef S" last="Smolen">Josef S. Smolen</name>
<name sortKey="Trauner, Michael" sort="Trauner, Michael" uniqKey="Trauner M" first="Michael" last="Trauner">Michael Trauner</name>
</country>
<country name="Japon">
<noRegion>
<name sortKey="Nishimoto, Norihiro" sort="Nishimoto, Norihiro" uniqKey="Nishimoto N" first="Norihiro" last="Nishimoto">Norihiro Nishimoto</name>
</noRegion>
<name sortKey="Murakami, Miho" sort="Murakami, Miho" uniqKey="Murakami M" first="Miho" last="Murakami">Miho Murakami</name>
<name sortKey="Tanaka, Yoshiya" sort="Tanaka, Yoshiya" uniqKey="Tanaka Y" first="Yoshiya" last="Tanaka">Yoshiya Tanaka</name>
</country>
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<region name="Hollande-Méridionale">
<name sortKey="Breedveld, Ferdinand C" sort="Breedveld, Ferdinand C" uniqKey="Breedveld F" first="Ferdinand C" last="Breedveld">Ferdinand C. Breedveld</name>
</region>
<name sortKey="De Wit, Maarten" sort="De Wit, Maarten" uniqKey="De Wit M" first="Maarten" last="De Wit">Maarten De Wit</name>
<name sortKey="Van Der Heijde, Desiree" sort="Van Der Heijde, Desiree" uniqKey="Van Der Heijde D" first="Désirée" last="Van Der Heijde">Désirée Van Der Heijde</name>
</country>
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<region name="Berlin">
<name sortKey="Burmester, Gerd R" sort="Burmester, Gerd R" uniqKey="Burmester G" first="Gerd R" last="Burmester">Gerd R. Burmester</name>
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<name sortKey="Rubbert Roth, Andrea" sort="Rubbert Roth, Andrea" uniqKey="Rubbert Roth A" first="Andrea" last="Rubbert-Roth">Andrea Rubbert-Roth</name>
</country>
<country name="France">
<region name="Île-de-France">
<name sortKey="Dougados, Maxime" sort="Dougados, Maxime" uniqKey="Dougados M" first="Maxime" last="Dougados">Maxime Dougados</name>
</region>
<name sortKey="Combe, Bernard" sort="Combe, Bernard" uniqKey="Combe B" first="Bernard" last="Combe">Bernard Combe</name>
</country>
<country name="Royaume-Uni">
<noRegion>
<name sortKey="Emery, Paul" sort="Emery, Paul" uniqKey="Emery P" first="Paul" last="Emery">Paul Emery</name>
</noRegion>
<name sortKey="Betteridge, Neil" sort="Betteridge, Neil" uniqKey="Betteridge N" first="Neil" last="Betteridge">Neil Betteridge</name>
<name sortKey="Choy, Ernest H" sort="Choy, Ernest H" uniqKey="Choy E" first="Ernest H" last="Choy">Ernest H. Choy</name>
<name sortKey="Sattar, Naveed" sort="Sattar, Naveed" uniqKey="Sattar N" first="Naveed" last="Sattar">Naveed Sattar</name>
</country>
<country name="Italie">
<region name="Latium">
<name sortKey="Ferraccioli, Gianfranco" sort="Ferraccioli, Gianfranco" uniqKey="Ferraccioli G" first="Gianfranco" last="Ferraccioli">Gianfranco Ferraccioli</name>
</region>
<name sortKey="Cutolo, Maurizio" sort="Cutolo, Maurizio" uniqKey="Cutolo M" first="Maurizio" last="Cutolo">Maurizio Cutolo</name>
<name sortKey="Montecucco, Carlomaurizio" sort="Montecucco, Carlomaurizio" uniqKey="Montecucco C" first="Carlomaurizio" last="Montecucco">Carlomaurizio Montecucco</name>
<name sortKey="Valentini, Gabriele" sort="Valentini, Gabriele" uniqKey="Valentini G" first="Gabriele" last="Valentini">Gabriele Valentini</name>
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<name sortKey="Gabay, Cem" sort="Gabay, Cem" uniqKey="Gabay C" first="Cem" last="Gabay">Cem Gabay</name>
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<name sortKey="Bykerk, Vivian" sort="Bykerk, Vivian" uniqKey="Bykerk V" first="Vivian" last="Bykerk">Vivian Bykerk</name>
<name sortKey="Scholte Voshaar, Marieke" sort="Scholte Voshaar, Marieke" uniqKey="Scholte Voshaar M" first="Marieke" last="Scholte-Voshaar">Marieke Scholte-Voshaar</name>
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<region name="État de New York">
<name sortKey="Gibofsky, Allan" sort="Gibofsky, Allan" uniqKey="Gibofsky A" first="Allan" last="Gibofsky">Allan Gibofsky</name>
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<name sortKey="Bingham, Clifton O" sort="Bingham, Clifton O" uniqKey="Bingham C" first="Clifton O" last="Bingham">Clifton O. Bingham</name>
<name sortKey="Winthrop, Kevin L" sort="Winthrop, Kevin L" uniqKey="Winthrop K" first="Kevin L" last="Winthrop">Kevin L. Winthrop</name>
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<name sortKey="Martin Mola, Emilio" sort="Martin Mola, Emilio" uniqKey="Martin Mola E" first="Emilio" last="Martin-Mola">Emilio Martin-Mola</name>
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<country name="République tchèque">
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<name sortKey="Pavelka, Karel" sort="Pavelka, Karel" uniqKey="Pavelka K" first="Karel" last="Pavelka">Karel Pavelka</name>
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