NICE anti-TNF therapy Decision
Recent announcements by the National Institute of Health and
Clinical Excellence (NICE), on the use of some ‘biologic treatments’ for people
with Rheumatoid Arthritis.
On 23rd April, NICE announced that it had rejected an appeal to allow the new,
clinically proven drug, Abatacept (Orencia), to be given to people in England
and Wales with severe Rheumatoid Arthritis. For some people, this means, having
failed to respond to all other types of treatments, they will be denied
Abatacept as a last chance of controlling the disease.
On 29th April a second announcement was made; this time on the sequential use of
anti-TNF therapy, a type of biologic treatment which may be more familiar to you
as these drugs have been in use for many years now.
As you may know, there are three anti-TNF treatments that are both licensed and
approved by NICE, they are Etanercept, (Enbrel), Infliximab (Remicade) and
Adalimumab (Humira). In recent years if someone has had a good response to an
anti-TNF drug but after a while that has diminished, they have had opportunity
to go onto a different anti-TNF drug and that often has had a beneficial
outcome. Some have even gained benefit from going onto a 3rd anti-TNF.
This is called sequential use of anti-TNF.
The NICE announcement recommends that people in England and Wales will no longer
be allowed to change to another anti-TNF if their original one gradually stops
having any effect. If this announcement by NICE is confirmed it will be a huge
backward step and severely limit the treatment options available to people with
Although you may think, this doesn't affect those with PR in most cases of
PR we are treated with the same medication used to treat RA. Also some of our
members have gone on to develop RA and this may be the case for you. Those
members that may be affected by this decision can send their comments to the
NRAS by the 16th May 2008 who will be passing on comments made to NICE..