@article{3003632,
    title = "International consensus: What else can we do to improve diagnosis and therapeutic strategies in patients affected by autoimmune rheumatic diseases (rheumatoid arthritis, spondyloarthritides, systemic sclerosis, systemic lupus erythematosus, antiphospholipid syndrome and Sjogren's syndrome)?: The unmet needs and the clinical grey zone in autoimmune disease management",
    author = "Giacomelli, R. and Afeltra, A. and Alunno, A. and Baldini, C. and Bartoloni-Bocci, E. and Berardicurti, O. and Carubbi, F. and Cauli, A. and Cervera, R. and Ciccia, F. and Cipriani, P. and Conti, F. and De Vita, S. and Di Benedetto, P. and Doria, A. and Drosos, A.A. and Favalli, E.G. and Gandolfo, S. and Gatto, M. and Grembiale, R.D. and Liakouli, V. and Lories, R. and Lubrano, E. and Lunardi, C. and Margiotta, D.P.E. and Massaro, L. and Meroni, P. and Minniti, A. and Navarini, L. and Pendolino, M. and Perosa, F. and Pers, J.-O. and Prete, M. and Priori, R. and Puppo, F. and Quartuccio, L. and Ruffatti, A. and Ruscitti, P. and Russo, B. and Sarzi-Puttini, P. and Shoenfeld, Y. and Somarakis, G.A. and Spinelli, F.R. and Tinazzi, E. and Triolo, G. and Ursini, F. and Valentini, G. and Valesini, G. and Vettori, S. and Vitali, C. and Tzioufas, A.G.",
    journal = "AUTOIMMUNITY REVIEWS",
    year = "2017",
    volume = "16",
    number = "9",
    pages = "911-924",
    publisher = "Elsevier B.V.",
    issn = "1568-9972",
    doi = "10.1016/j.autrev.2017.07.012",
    keywords = "abatacept;  adalimumab;  anticoagulant agent;  belimumab;  beta2 glycoprotein 1;  biological marker;  biological product;  biosimilar agent;  C reactive protein;  cardiolipin antibody;  corticosteroid;  cyclic citrullinated peptide antibody;  disease modifying antirheumatic drug;  etanercept;  hydroxychloroquine;  imatinib;  immunoglobulin;  infliximab;  methotrexate;  mycophenolic acid;  rheumatoid factor;  rituximab;  salazosulfapyridine;  tocilizumab;  tumor necrosis factor inhibitor, Ankylosing Spondylitis Disease Activity Score;  anticoagulant therapy;  antiphospholipid syndrome;  apheresis;  artery thrombosis;  arthritis;  clinical outcome;  combination drug therapy;  consensus;  disease activity;  disease course;  disease exacerbation;  drug efficacy;  drug retention;  erythrocyte sedimentation rate;  functional status;  gold standard;  heart muscle fibrosis;  hematopoietic stem cell transplantation;  hemolytic anemia;  high risk patient;  human;  interstitial lung disease;  intestinal fibrosis;  lupus erythematosus nephritis;  monotherapy;  personalized medicine;  randomized controlled trial (topic);  recurrent disease;  relapse;  remission;  Review;  rheumatoid arthritis;  sacroiliac joint;  sex difference;  Sjoegren syndrome;  skin malformation;  spondylarthritis;  spontaneous abortion;  survival;  systemic lupus erythematosus;  systemic sclerosis;  thrombocytopenia;  treatment response;  vasculitis;  autoimmune disease;  clinical trial (topic);  consensus development;  disease management;  immunology;  rheumatic disease;  total quality management, Autoimmune Diseases;  Clinical Trials as Topic;  Disease Management;  Humans;  Quality Improvement;  Rheumatic Diseases",
    abstract = "Autoimmune diseases are a complex set of diseases characterized by immune system activation and, although many progresses have been done in the last 15 years, several unmet needs in the management of these patients may be still identified. Recently, a panel of international Experts, divided in different working groups according to their clinical and scientific expertise, were asked to identify, debate and formulate a list of key unmet needs within the field of rheumatology, serving as a roadmap for research as well as support for clinicians. After a systematic review of the literature, the results and the discussions from each working group were summarised in different statements. Due to the differences among the diseases and their heterogeneity, a large number of statements was produced and voted by the Experts to reach a consensus in a plenary session. At all the steps of this process, including the initial discussions by the steering committee, the identification of the unmet needs, the expansion of the working group and finally the development of statements, a large agreement was attained. This work confirmed that several unmet needs may be identified and despite the development of new therapeutic strategies as well as a better understanding of the effects of existing therapies, many open questions still remain in this field, suggesting a research agenda for the future and specific clinical suggestions which may allow physicians to better manage those clinical conditions still lacking of scientific clarity. © 2017"
}