NICE releases guidance for the use of biologics in the treatment of RA
The National Institute for Health and Care (NICE) has released new guidance for the use of biologics to treat some people with severe rheumatoid arthritis. The new guidance does not recommend their use for treating moderate active rheumatoid arthritis.
Treatment for rheumatoid arthritis includes a group of drugs called disease-modifying anti-rheumatic drugs (DMARDs). These drugs improve symptoms and slow down joint damage. However, the conventional “non-biological” type of DMARDs are not suitable for everyone, and some people’s rheumatoid arthritis does not respond well to them.
The recommended biological DMARDs are adalimumab; etanercept; infliximab; certolizumab pegol; golimumab; tocilizumab and abatacept, either in combination with methotrexate or as monotherapy for people with severe symptoms who cannot take methotrexate because it is contraindicated or because of intolerance.
These biologics reduce inflammation in the body so that swelling in the joints is reduced and further damage may be prevented. They are possible treatments for people with rheumatoid arthritis, only if their disease is severe and has not responded to treatment with a combination of conventional DMARDs.
Adalimumab, etanercept, certolizumab pegol and tocilizumab can be used alone by people who cannot have methotrexate. The guidance also advices that treatment should be stopped after six months if the person’s rheumatoid arthritis is not responding well enough.
Professor Carole Longson MBE, director of the Health Technology Evaluation Centre at NICE, said: ‘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.
‘In recommending them as options for people with severe rheumatoid arthritis after previous treatment with conventional DMARDs 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.’
Image credit: Canan Star
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