Evidence-based recommendations on adalimumab (Humira), certolizumab pegol (Cimzia), etanercept (Enbrel), golimumab (Simponi) and infliximab (Remicade, Remsima, Inflectra). These drugs are for people with severe active ankylosing spondylitis or severe non-radiographic axial spondyloarthritis who have tried non-steroidal anti-inflammatory drugs (NSAIDs), but they have not worked.

The recommendations also apply to biosimilar products of these technologies that have a marketing authorisation allowing the use of the biosimilar for the same indication.

The guidance has been incorporated into NICE’s guideline on spondyloarthritis in over 16s: diagnosis and management (NG65).

Is this guidance up to date?

We reviewed the evidence in March 2019. We found nothing new that affects the recommendations in this guidance.

Next review: This guidance will be reviewed if there is new evidence that is likely to affect the recommendations.

Guidance development process

How we develop NICE technology appraisal guidance

This guidance replaces NICE technology appraisal guidance on adalimumab, etanercept and infliximab for ankylosing spondylitis (TA143) and golimumab for the treatment of ankylosing spondylitis (TA233).

Your responsibility

The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE)