Meeting report (part 1): Biological treatment of rheumatic diseases with special focus on T cell modulation

Meeting report (part 1): Biological treatment of rheumatic diseases with special focus on T cell modulation
Venue: Karolinska Institute, Department of Rheumatology, Stockholm, Sweden.
Date: 22-23 November, 2011.
Participants: approx. 30 rheumatologists from 9 different European countries (Sweden, United Kingdom, the Netherlands, Belgium, France, Germany, Czech Republic, Austria, Spain)

Invited by BMS, a major pharmaceutical company that co-sponsored this meeting, rheumatologists from 9 countries throughout Europe gathered for a 2-day visit at the EULAR Center of Excellence in the department of Rheumatology at the Karolinksa Institute (KI) in Sweden last week. Being a participant in this interesting and well-organised meeting I wrote down some notes during the lectures that were given, and I thought to share them here. Feel free to comment.

Day 1 (Tuseday November 22nd, 2011)
Despite foggy weather conditions in the Netherlands we managed to arrive in Stockholm the evening before the meeting started, and we stayed in the Berns Solanger hotel in the centre of Stockholm, a very nice ans special location. On Tuesday the meeting was kicked-off by some brief introductions to the magnitude, location and organisation of the rheumatology care in Stockholm and direct surroundings were 2 of the 9 million inhabitants of Sweden live. The introduction talks were given by Cecilia Carlens, head of Dept of Rheumatology at KI, and Magnus Andersson Sandqvist who was the friendly chairman during the 2-day visit.

The Karolinska Institute delivers the core of rheumatology care in Sweden, and all more advanced rheumatological cases are treated either in Solna, Stockholm at the Institute or in a second more southern situated location Huddinge which is of equal dimensions. The major part of this meeting was held in the Center for Molecular Medicine research buidling which is located less then 100 yards from the Department of Rheumatology (on the photo snapshot) just on the opposite side of the street (i.e. untill the currently being built new Karolinska Hospital opens in 2015, which will be slightly further away but also on walking distance). Quite remarkable figures and facts stated in the introduction talks were that over 25% of the 10,000 outpatient-clinic patients that are being taken care of are on biological treatment, which is so far quite unrestricted in Sweden, but may quite vary per region in Sweden. However it is fair to say that the nurses in the daycare unit at the Department of Rheumatology in the Karolinska Institute (about 20 intravenous treatments per day) are by far the most experienced ones in Sweden and probably in the whole of Europe as far as intravenous treatment with biological agents in rheumatic diseases concerns. Combining this with the excellent Swedisch Registry system -that includes all 9 million inhabitants of the country and which started in 1995 for rheumatology- offers a great source of information on efficacy and safety of these (expensive but powerful) drugs that are so widely used in rheumatology clinical practice worldwide. Furthermore it was stated that at the moment 12 different clinical trials are ongoing at KI and about 10 million euro research funds are available on annual base to perform clinical and laboratory research. In the Stockhom area there are about 10 private (outpatient-only) clinics in the field of rheumatology (the only ones in Sweden) and their number may rise sharply when the new Karolinska Insititute Hospital is opened (the strategy of the new hospital focuses on smaller dimensions then the current hospital which most probably will cause a shift from the very crowded outpatient clinics at KI to a number of private clinics for the less severe cases that do not require hospitalisation).