NICE recommends 2nd Anti-TNF and Abatacept as treatment options, in certain circumstances, for Rheumatoid Arthritis following failure of a first Anti-TNF

On Friday 25th June, NICE issued long awaited guidance about treatment options for adults with severe active rheumatoid arthritis who have had an inadequate response to, or have an intolerance of, other DMARDs, including at least one TNF inhibitor.

This Final Appraisal Document reverses the results of both an earlier NICE appraisal in 2007 and a draft guidance published in February 2010. The new guidance allows, for the first time, greater access to a range of biologic therapies following failure of a first TNF, which NRAS have been strenuously campaigning for since the guidance issued in 2007 which was overturned at the time on appeal.

The new guidance states that Adalimumab (Humira), Etanercept (Enbrel), infliximab (Remicade) and abatacept (Orenzia) are recommended as treatment options only for adults with severe active rheumatoid arthritis who have had an inadequate response to, or have an intolerance of, other DMARDs, including at least one TNF inhibitor, and who have a contraindication to rituximab or methotrexate, or when rituximab or methotrexate is withdrawn because of an adverse event.

NRAS welcomes this guidance as it will enable many people to continue to have access to biologic therapies instead of having no option but to return to DMARDS which they have failed and continued use of steroids.

Please click here to download the full guidance (PDF), or visit the NICE website for more information.

Ailsa Bosworth, CEO of NRAS said “As an expert patient working on the NICE Technology Appraisal throughout this process to represent the needs of people with RA, I am both surprised and delighted at this outcome. It’s been a long battle but it makes economic sense because it will enable people to remain independent and working, and gives patients and clinicians more choice and control over management of their disease which is what we need.”

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