Evidence-based recommendations on adalimumab (Humira), etanercept (Enbrel), infliximab (Remicade, Remsima, Inflectra), certolizumab pegol (Cimzia), golimumab (Simponi), tocilizumab (RoActemra) and abatacept (Orencia). These drugs are for adults with severe rheumatoid arthritis who have tried conventional DMARDs only but they have not worked.
The recommendations also apply to biosimilar products of the technologies that have a marketing authorisation allowing the use of the biosimilar for the same indication.
Some of the treatments recommended in this appraisal for severe rheumatoid arthritis are also recommended for moderate rheumatoid arthritis. See NICE technology appraisal guidance 715 for details.
Is this guidance up to date?
We reviewed the evidence in September 2019 and we are updating the guidance for people with moderate disease.
There is a simple discount patient access scheme for abatacept. Contact UKCommercialEnquiries@bms.com for details.
There is a complex patient access scheme for certolizumab pegol. Contact UCBCares.UK@ucb.com for details.
There is a complex patient access scheme for golimumab. Contact email@example.com for details.
There is a simple discount patient access scheme for tocilizumab. Contact Welwyn.firstname.lastname@example.org for details.
Guidance development process
This guidance replaces NICE technology appraisal guidance on:
- adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis (TA130)
- certolizumab pegol for the treatment of rheumatoid arthritis (TA186)
- golimumab for the treatment of methotrexate-naive rheumatoid arthritis (TA224) and
- abatacept for treating rheumatoid arthritis after the failure of conventional disease-modifying anti-rheumatic drugs (TA280).
It partially updates golimumab for the treatment of rheumatoid arthritis after the failure of previous disease-modifying anti-rheumatic drugs (TA225) and tocilizumab for the treatment of rheumatoid arthritis (TA247).
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.