NICE updates guidance for arthritis treatments
pharmafile | August 26, 2010 | News story | Sales and Marketing | NICE, Roche, rheumatoid arthritis
Five new drugs for rheumatoid arthritis have been given the thumbs up by NICE as second line treatment.
Roche’s MabThera, Abbott’s Humira, Pfizer/Amgen’s Enbrel, Merck’s Remicade and Bristol-Myers Squibb’s Orencia can be used as possible treatments for rheumatoid arthritis (RA) after treatment with a tumour necrosis factor (TNF) drugs has failed.
Dr Carole Longson, director of the health technology evaluation centre at NICE, said: “We have already recommended the TNF inhibitors Humira, Enbrel and Remicade for some people with rheumatoid arthritis as options for use after treatment with conventional drugs.
“In the first new piece of guidance we recommend treatment options when a TNF inhibitor has not worked or when it has lost its effect. The evidence suggests that MabThera works in this context and is a cost-effective treatment option.
“As not all patients are able to take MabThera, the guidance recommends that Humira, Enbrel, Remicade or Orencia, each in combination with methotrexate [a folic acid inhibitor] may be given.
“For patients who cannot take MabThera because methotrexate is contraindicated or has been withdrawn, then Humira or Enbrel given as monotherapy is recommended. This guidance updates and replaces previous NICE guidance on treatments received at this point in the pathway of care.”
In an emailed statement, Dr Cristina Estrach, rheumatology consultant and honorary lecturer at University Hospital Aintree, Liverpool, said: “This is an important advance for clinicians and equally for patients.
“RA is a complicated disease which means not all patients can respond to the same treatments. Therefore, today’s announcement is a step closer to ensuring that patients have greater access to effective treatments that will help maintain control of their disease.”
Boost for Roche
Meanwhile, in separate guidance, NICE has recommended Roche’s RoActemra plus methotrexate (MTX) for use in rheumatoid arthritis (RA) patients who have failed on or are contraindicated for the firm’s arthritis drug MabThera.
The drugs watchdog said that this would give greater access to RA treatments in the UK who have only limited treatment options left after failing on MabThera.
This will be a boost for Roche as both of its top arthritis treatments have now been recommended for use in the NHS.
It has not always been smooth sailing for the drug, as NICE was minded to reject the treatment back in March over questions on cost-effectiveness.
In clinical trials RoActemra, given with MTX, achieved clinical remission rates almost six times higher than MTX alone, showing 47% versus 8 per cent. It also halted joint damage in 85% of patients compared to 67% when treated with just MTX over one year.
NICE updated its arthritis guidance in June to allow greater access to RA drugs and this is a further update to this process.
The full guidance can be found here.
Ben Adams
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