The National Institute for Heath and Care Excellence (NICE) – a UK cost-effectiveness agency – is backing seven biological disease modifying drugs designed to treat severe rheumatoid arthritis. The recommended drugs are to be prescribed to patients who are unresponsive to convention therapies, and are not designed to treat moderate active rheumatoid arthritis.
The document recommends AbbVie’s Humira (adalimumab); Pfizer’s Enbrel (etanercept); Merck Sharp & Dohme’s (MSD) Remicade (infliximab) and biosimilars by Hospira UK (Inflectra) and Napp Pharmaceuticals (Remsima); UCB Pharma’s Cimzia (certolizumab); MSD’s Simponi (golimumab); Roche’s RoActemra (tocilizumab); and Bristol-Myers Squibb’s Orencia (abatacept). Each of the drugs is designed to be used in combination with methotrexate.
According to NICE, RoActemra, Cimzia, Enbrel and Humira can also be used as monotherapies for patients with severe forms of rheumatoid arthritis who cannot tolerate methotrexate. Groups including the National Rheumatoid Arthritis Society urged the regulators to include patient groups with moderate forms of the disease in the draft guidance, but were unsuccessful in their appeals.
Rheumatoid arthritis is a chronic autoimmune disease in which the patient’s hands and feet become stiff, swollen and painful due to inflammation in the synovial joints. Approximately 400,000 people in the UK suffer from the disease, with about 15 percent of them experiencing severe rheumatoid arthritis.
While the disease can begin to develop at any age, the average age of onset in the UK is between 40 to 70 years old. Disease-modifying antirheumatic drugs slow the progression of the disease by targeting and blocking components of the immune system to prevent further damage to joints.
“This guidance considers at what stage it’s clinically and cost effective to start using biological therapies as treatment options for adults with rheumatoid arthritis,” said the director of the Health Technology Evaluation Centre at NICE, Carole Longson. “In recommending them as options for people with severe rheumatoid arthritis after previous treatment with conventional disease-modifying antirheumatic drugs has been unsuccessful, this guidance reaffirms our previous recommendations on these drugs and confirms their place as an integral part of the rheumatoid arthritis treatment pathway.”