Golimumab (Simponi), taken with a drug called methotrexate, is recommended as a possible treatment for some adults with severe active rheumatoid arthritis in the same circumstances as other drugs for the condition1. They should be able to have golimumab if they have already tried other types of disease-modifying anti-rheumatic drugs (DMARDs), including a DMARD known as a tumour necrosis factor (or TNF for short) inhibitor, but these drugs haven’t worked and they cannot take rituximab therapy for medical reasons or because they had a bad reaction to it.
Treatment should be carried out by a specialist rheumatology team. After the first 6 months golimumab therapy can continue only if it is clearly improving the person’s rheumatoid arthritis. They should have check-ups every 6 months after that to make sure golimumab therapy is still working.
When assessing your rheumatoid arthritis, healthcare professionals should take into account any disabilities or difficulties in communicating you may have.
What does this mean for me?
If you have rheumatoid arthritis, and your doctor thinks that golimumab is the right treatment, you should be able to have the treatment on the NHS.
Golimumab should be available on the NHS within 3 months of the guidance being issued.
If you are not eligible for treatment as described above, you should be able to continue taking golimumab until you and your doctor decide it is the right time to stop.
This guidance has been updated by NICE technology appraisal guidance on adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed (TA375).
1 The circumstances described in this section are the same circumstances in which NICE recommends adalimumab, etanercept, infliximab, rituximab and abatacept.
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.
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.