Patients in England and Wales with ankylosing spondylitis could soon routinely access a wider list of biologic therapies on the National Health Service following new preliminary recommendations from the National Institute for Health and Care Excellence. 

In draft guidelines, the Institute has re-affirmed endorsement of AbbVie’s Humira (adalimumab), Pfizer’s Enbrel (etanercept) and Merck Sharp & Dohme’s Simponi (golimumab) as clinically and cost-effective therapies for the condition, a form of spinal arthritis predominantly affecting young males.

But it has also recommended UCB Pharma’s Cimzia (certolizumab pegol) and MSD’s Remicade (infliximab), as well as biosimilar versions of the latter - Napp Pharmaceuticals’ Remsima and Hospira UK’s Inflectra - for NHS use in this setting.

The guidance also covers non-radiographic axial spondyloarthritis - a group of rheumatic diseases characterised by common clinical features, most commonly inflammatory back pain, but not visible by X-ray - provisionally recommending Humira, Cimzia and Enbrel as treatment options for adults.

Access to biologics maintained for RA patients

Last week the Institute also published a draft final appraisal determination for rheumatoid arthritis, provisionally recommending continued access to biologic medicines Roche’s MabThera (rituximab), Enbrel, Humira and infliximab for patients living with severe forms of the disease.

But drugmaker UCB said whilst it is “heartened” to see that NICE is planning to maintain access, “it is important to highlight that, in comparison to other European countries, patients in the UK have a lower access to the use of biological disease-modifying anti-rheumatic drugs”. 

According to a 2009 National Audit Office report, the prevalence of patients on biological medicines was around 6% in the UK, whereas in other EU countries, including Spain, France, Netherlands and Sweden, it ranged between 8%-12%.

Julian Maitland, UCB’s Medical Director of Immunology, said biologics are “highly effective treatments for the management of what can be a seriously debilitating disease,” and NICE’s decision “should provide a renewed impetus to ensure that all eligible NHS patients receive them in a timely manner”.