Tocilizumab (RoActemra), taken with a drug called methotrexate, is recommended as a possible treatment for some adults with rheumatoid arthritis if:
- they have tried disease-modifying anti-rheumatic drugs (DMARDs) and a TNF inhibitor but they have not worked, and they cannot have rituximab for medical reasons or because of a bad reaction, as long as tocilizumab is used 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
- they have tried TNF inhibitors and rituximab but they have not worked.
What does this mean for me?
If you have rheumatoid arthritis, and your doctor thinks that tocilizumab is the right treatment, you should be able to have the treatment on the NHS.
Tocilizumab 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 tocilizumab until you and your doctor decide it is the right time to stop.
This guidance replaced NICE technology appraisal guidance on tocilizumab for the treatment of rheumatoid arthritis (TA198).
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).
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.