This guidance updates and replaces NICE technology appraisal 198 (published in August 2010).
NICE recommends tocilizumab, taken with a drug called methotrexate, as a possible treatment for some people with rheumatoid arthritis (see below).
Who can have tocilizumab?
You should be able to have tocilizumab if:
- you have tried disease-modifying anti-rheumatic drugs (DMARDs for short) but they have not worked, as long as tocilizumab is used in the same way that NICE recommends drugs called tumour necrosis factor (TNF for short) inhibitors are used in its guidance adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis or
- you have tried DMARDs and a TNF inhibitor but they have not worked, and you cannot have rituximab for medical reasons or because of a bad reaction, as long as tocilizumab is used as in the same way that NICE recommends TNF inhibitors are used in adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a TNF inhibitor or
- you have tried TNF inhibitors and rituximab but they have not worked.
Why has NICE said this?
NICE looks at how well treatments work, and also at how well they work in relation to how much they cost the NHS. NICE recommended tocilizumab in these circumstances because it works well and its cost is justified after other drugs have been tried.