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Published on 25 June 2010

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Nice changes guidance on RA drugs

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The health watchdog has reversed a decision which will now herald the chance for thousands of rheumatoid arthritis sufferers to try new drugs.

Two years ago the National Institute for Health and Clinical Excellence (Nice) made a decision to deny a range of drugs to patients, but it has effectively made a U-turn in that regard.

Nice ruled in 2008 that sufferers would not be allowed to try a second anti-TNF (tumour necrosis factor alpha inhibitor) if their first attempt at anti-TNF therapy failed.

New guidance was issued by Nice in March putting forward the use of a drug called rituximab (MabThera), but saying adalimumab (Humira), etanercept (Enbrel) and infliximab (Remicade) could only be used in the context of research, even for those patients who had failed on one anti-TNF.

The watchdog also rejected abatacept in that guidance.

Now, in new draft guidance, Nice recommends rituximab as the treatment for patients who have failed on an anti-TNF or who have not responded to other disease-modifying anti-rheumatic drugs.

But it also recommends adalimumab, etanercept, infliximab and abatacept for patients who have failed on one anti-TNF or who have not responded to other disease-modifying anti-rheumatic drugs, and who cannot take rituximab.

It said rituximab should not be given more often than every six months and should only be continued if there is an adequate response.

The other drugs should only be given if there is a good response six months after the start of therapy.

Copyright Press Association 2010



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