NICE has today (10th June) published final draft guidance which recommends several treatment options for around 25,000 people with moderate rheumatoid arthritis that have not responded to conventional therapies.
Adalimumab, etanercept and infliximab, taken with methotrexate have been recommended for use within the NHS. Adalimumab and etanercept can also be used as monotherapy when methotrexate is contraindicated or not tolerated.
NICE has previously recommended biological treatments only for severe rheumatoid arthritis. This guidance was reviewed because biosimilars have become available, meaning that these treatments are now available to the NHS at a lower price. A biosimilar medicine is a medicine that is developed to be similar to an existing biological medicine.
Meindert Boysen, deputy chief executive and director of the Centre for Health Technology Evaluation at NICE said: “I am delighted that we are able to recommend additional treatment options for people with moderate rheumatoid arthritis whose disease hasn’t responded to conventional treatments.
“These recommendations come after a pragmatic review of existing guidance in response to the availability of biosimilars in the NHS. We are pleased that the introduction of biosimilars has lowered overall costs of treatment, allowing our independent committee to recommend biological treatment for more people with rheumatoid arthritis so they can enjoy a better quality of life.”
Clinical trial evidence suggests the treatments provide similar benefits for people with moderate disease as well as those with severe disease.
The treatments have been recommended only if intensive therapy with two or more conventional disease-modifying antirheumatic drugs DMARDS have not controlled the disease.
Rheumatoid arthritis is an incurable chronic systemic inflammatory autoimmune disease in which the synovial joints (such as those in the hands and feet) become inflamed, causing pain, swelling and stiffness.
The disease affects a total of around 400,000 people in the UK, with over 150,000 having moderate rheumatoid arthritis. This means over 15% of those people with moderate rheumatoid arthritis that has not responded to conventional therapies are set to benefit from this recommendation. It is about 2–4 times more common in women than in men. It can develop at any age, but the peak age of onset in the UK is about 40–70 years.