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A generation ago, in the 1960s, many exciting developments were taking place in rheumatology. Clinical studies were greatly improving the classification of the systemic rheumatic diseases, basic research was elucidating the immune system and its central involvement in the pathogenesis of many diseases, and controlled clinical trials were beginning to validate the effectiveness of some treatments. During the ensuing two decades there were few important therapeutic advances. Now, rheumatology may be on the threshold of a new era with the emergence of specific biologic agents that target selected cell-surface antigens and proinflammatory cytokines and the development of strategies in which
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