The National Institute for Health and Care Excellence has published final draft guidelines recommending four drugs to treata form of arthritis in children and young people. 

The Institute has provisionally recommended Bristol-Myers Squibb’s Orencia (abatacept), AbbVie’s Humira (adalimumab), Pfizer’s Enbrel (etanercept) and Roche RoActemtra (tocilizumab), within their marketing authorisations, as options for treating juvenile ideopathic arthritis (JIA). 

Around 10,000 children and young people in the UK are affected by JIA, an umbrella term that describes a group of conditions involving joint inflammation lasting longer than six weeks in children aged under 16 years, causing pain, swelling and limitation of movement. 

Treatment aims are to control joint pain and inflammation, reduce joint damage, disability and loss of function and maintain or improve quality of life, NICE said, but also noted that despite current treatment around a third of children will not achieve remission from the condition and will need further care in adulthood. 

The therapies recommend for National Health Service use in England and Wales are all so-called disease-modifying anti-rheumatic drugs (DMARDs) that aim to slow down or stop joint damage, and are all approved for use where previous treatment has evoked an inadequate response or intolerance. 

The draft guidance stipulates that, if more than one drug is found to be suitable, treatment should commence with the cheapest, taking into account administration costs, dosing and cost.