RA hope as NICE set to reconsider guidance

NICE is to reconsider its draft guidance on the use of a second anti-tumour-necrosis factor (TNF) drug for the treatment of rheumatoid arthritis (RA).

The move comes after an appeal by the Royal College of Nursing, a number of charities including Arthritis Care, and drug manufacturers Abbot Laboratories, Wyeth Pharmaceuticals and Schering-Plough.

The drugs concerned in the NICE appeal are infliximab (Remicade), etanercept (Enbrel) and adalimumab (Humira).

The draft NICE guidance, which was issued last November, states patients with RA in whom first anti-TNF treatment fails should not be offered an alternative anti-TNF drug.

But NICE's own appeal panel announced that the NICE Health Technology Appraisal Committee had been 'unreasonable' in deciding to deny patients a second anti-TNF treatment. The NICE guidance must be reconsidered by the committee.

If NICE offers the same advice, after examining all available evidence, then it should fully explain the reasons behind their decision, says the appeal panel.

Neil Betteridge, chief executive of Arthritis Care, said that the decision to reconsider the guidance offered hope for people with severe forms of RA.

Ailsa Bosworth, chief executive of the National Rheumatoid Arthritis Society, welcomed the decision.

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