Clinical Rheumatology

, Volume 31, Issue 3, pp 407–416 | Cite as

The practical value of biologics registries in Africa and Middle East: challenges and opportunities

  • Najia Hajjaj-HassouniEmail author
  • Marzooq Al-Badi
  • Ala’ Al-Heresh
  • Samar Al-Emadi
  • Ahmed El Bawendi
  • Ayman El Garf
  • Khaled El Hadidi
  • Hussein Halabi
  • Mohammed Hammoudeh
  • Selma El Hassani
  • Mustafa Al Maaini
  • Ibrahim Nahar
  • Aïcha Ladjouze Rezig
  • Slaheddine Sellami
  • Wafaa Sweiri
  • Ramiz Alswailem
  • Beverly Traub
  • Imad Uthman
  • Elsa van Duuren
  • Leith Zakraoui
  • Bassel El Zorkany
  • Loreto Carmona
  • Maxime Dougados
Review Article


Biologics, including tumor necrosis factor (TNF) inhibitors, are increasingly used for the treatment of inflammatory conditions such as rheumatoid arthritis (RA), psoriatic arthritis, and ankylosing spondylitis. The efficacy of these drugs has been demonstrated in randomized controlled trials (RCTs). However, these studies are conducted in controlled environments, and the results may not necessarily reflect clinical outcomes in daily clinical practice. In Europe and other western countries, numerous biologics registries that enroll and monitor patients receiving biologics have been established. These registries follow patients irrespective of whether they continue with the initial biologic drug. Thus, real-life efficacy data from these registries can be used to assess the long-term safety of biologics through longitudinal studies. In Africa and Middle East (AFME), such registries currently exist only in Morocco and South Africa. In light of the increasing availability of biologics and scarcity of long-term safety data of these agents in the AFME population, there is a need to establish biologics registries in other countries across the region. This review discusses the value of biologics registries versus RCTs as well as safety and efficacy data from observational studies presented as lessons from well-established biologics registries. In addition, the rationale for establishing such registries in the AFME region is also presented.


Africa and Middle East Biologics Registries Rheumatoid arthritis Safety Tumor necrosis factor inhibitors 



We would like to thank Dr. Pradnya Kulkarni from UBM Medica for editorial support. Funding for the initial working group meeting and editorial support was provided by Pfizer.




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Copyright information

© Clinical Rheumatology 2012

Authors and Affiliations

  • Najia Hajjaj-Hassouni
    • 1
    • 2
    Email author
  • Marzooq Al-Badi
    • 3
  • Ala’ Al-Heresh
    • 4
  • Samar Al-Emadi
    • 5
  • Ahmed El Bawendi
    • 8
  • Ayman El Garf
    • 10
  • Khaled El Hadidi
    • 11
  • Hussein Halabi
    • 12
  • Mohammed Hammoudeh
    • 13
  • Selma El Hassani
    • 14
  • Mustafa Al Maaini
    • 7
  • Ibrahim Nahar
    • 15
  • Aïcha Ladjouze Rezig
    • 16
  • Slaheddine Sellami
    • 17
  • Wafaa Sweiri
    • 18
  • Ramiz Alswailem
    • 6
  • Beverly Traub
    • 19
  • Imad Uthman
    • 20
  • Elsa van Duuren
    • 9
  • Leith Zakraoui
    • 21
  • Bassel El Zorkany
    • 22
  • Loreto Carmona
    • 23
  • Maxime Dougados
    • 24
  1. 1.University Mohammed Vth SouissiRabatMorocco
  2. 2.El Ayachi HospitalSaléMorocco
  3. 3.Security Force HospitalRiyadhSaudi Arabia
  4. 4.King Hussein Medical Center, Royal Medical ServicesAmmanJordan
  5. 5.Weill Cornell Medical SchoolDohaQatar
  6. 6.Riyadh Military HospitalRiyadhSaudi Arabia
  7. 7.Mafraq HospitalAbu DhabiUnited Arab Emirates
  8. 8.Tripoli Medical CenterTripoliLibya
  9. 9.Jakaranda HospitalPretoriaSouth Africa
  10. 10.Cairo University HospitalsCairoEgypt
  11. 11.Cairo UniversityGizaEgypt
  12. 12.King Faisal Specialist Hospital and Research Center—JeddahRiyadhKingdom of Saudi Arabia
  13. 13.Hamad Medical CorporationDohaQatar
  14. 14.Faculté de Médecine et de Pharmacie de MarrakechUniversité Cadi AyyadSidi AbbadMorocco
  15. 15.Department of MedicineMubarak Al-Kabir HospitalKuwait CityKuwait
  16. 16.Service Rhumatologie, Hôpital Ben Aknoun, EHS Appareil LocomoteurAlgerAlgéria
  17. 17.EPS La RabtaTunisTunisia
  18. 18.King Abdul Aziz Medical City, King Fahad National Guard HospitalRiyadhSaudi Arabia
  19. 19.EppsteinGermany
  20. 20.American University of Beirut Medical CenterBeirutLebanon
  21. 21.Hôpital Mongi SlimUniversity of Tunis El ManarLa MarsaTunisia
  22. 22.Rheumatology Department, Kasr El-Aini HospitalsCairo UniversityCairoEgypt
  23. 23.Health Sciences SchoolUniversidad Camilo José CelaMadridSpain
  24. 24.UPRES-EA 4058, APHP, Cochin HospitalParis-Descartes UniversityParisFrance

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