Recommendation ID

Biological therapies for peripheral spondyloarthritis:- What is the effectiveness and cost effectiveness of biological DMARDs in people with persistent peripheral spondyloarthritis (excluding psoriatic arthritis) or undifferentiated spondyloarthritis?

Any explanatory notes
(if applicable)

Why this is important:- Although there have been trials conducted of biological therapies for psoriatic arthritis, which have led to positive recommendations in NICE technology appraisals, no such good-quality evidence exists in enteropathic arthritis, reactive arthritis or undifferentiated spondyloarthritis. The substantial side effects possible with biological therapies, and their significant cost, means it is difficult to justify offering them to these groups without good evidence of efficacy. There is therefore the need for randomised controlled trials, with a sufficient sample size to identify possible benefits, in these 3 populations. If trials were to recruit participants from multiple spondyloarthritis subpopulations, results should be clearly stratified by diagnosis to enable any differences in benefits or harms between the groups to be identified. These trials should include (as outcome measures) both health-related quality of life (measured using the EQ-5D) and health service resource use, to enable the results to be used to assess the cost effectiveness of the interventions.

Source guidance details

Comes from guidance
Spondyloarthritis in over 16s: diagnosis and management
Date issued
February 2017

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 28/02/2017