BSR statement on NICE FAD on adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis (RA) after the failure of a TNF inhibitor

NICE have published guidelines on sequential therapy for patients failing a first anti-TNF. Although most patients will then go onto rituximab and methotrexate, if patients have contra-indications to either of these drugs, or show early toxicity once they have been exposed to them, they would be entitled to a second anti-TNF or abatacept.

BSR welcomes this ruling from NICE, whilst recognising that limitations are still present. In responding to the appraisal determination, BSR members and appraisal consultees, Dr Chris Deighton and Dr Frank McKenna, commented that the FAD is positive, particularly by providing opportunities to access treatments such as abatacept.

Dr Deighton and Dr McKenna commented: “On the whole this ruling is a positive step forward, and testimony to the perseverance of many stakeholders over the years in trying to gain access to more choice in biologic drugs for patients with severe RA who fail to respond to the first anti-TNF. However we remain concerned that patients who fail on rituximab will only have the option of returning to conventional DMARDs and palliative care. “

For further information contact:

Debbie Smith at dsmith@rheumatology.org.uk or
Rachel Evans at revans@rheumatology.org.uk

View the full FAD