The National Institute for Health and Clinical Excellence has endorsed the use of anti- tumour necrosis factor alpha therapies as an option for adults seeking treatment for rheumatoid arthritis on the National Health Service.

Specifically, Abbott’s Humira (adalimumab), Johnson & Johnson/Schering-Plough’s Remicade (infliximab) and Wyeth/Amgen’s Enbrel (etanercept), have been recommended for use in patients who have not responded to two previous courses of therapy with disease-modifying anti-rheumatic drugs.

RA, a chronic and progressive disabling condition characterised by inflammation of the synovial tissue of the joints, affects over half a million people in the UK and, according to Abbott, the total cost of the disease in terms of health expenditure and lost working days is around £3.8-£4.75 billion each year.

“People living with rheumatoid arthritis will welcome today’s recommendation from NICE,” commented Ailsa Bosworth, Chief Executive of the National Rheumatoid Arthritis Society. “In order to effectively manage RA, it is crucial that those of us with the disease have access to the right treatment at the right time. NICE’s decision means there are more options – and fewer barriers – to people with RA having access to treatments that work,” she explained.

Cycling therapy

In a separate issue regarding the anti-TNF therapies, an appeal committee earlier this year forced the Institute to reconsider its stance on cycling their use in patients with RA.

NICE had decided that if patients had not responded to therapy with one anti-TNF agent, they should not be switched to another, prompting outrage from many factions in the industry and a subsequent appeal by Abbott Laboratories Ltd, Arthritis and Musculoskeletal Alliance, National Rheumatoid Arthritis Society, Royal College of Nursing, Schering-Plough Ltd and Wyeth Pharmaceuticals.

Following assessment on the sequential use of these treatments, separate guidance will be issued by the Institute next year, it said.