The National Health Institute for Health and Clinical Excellence will reconsider its stance on cycling the use of anti-tumour necrosis factor therapies in patients with rheumatoid arthritis, after an appeal panel ruled that it should reassess the data.

Three anti-TNF therapies are currently licensed for the treatment of RA – Abbott’s Humira (adalimumab), Johnson & Johnson/Schering-Plough’s Remicade (infliximab) and Wyeth/Amgen’s Enbrel (etanercept).

But, in November last year, the Institute 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 (ARMA), National Rheumatoid Arthritis Society (NRAS), Royal College of Nursing (RCN), Schering-Plough Ltd and Wyeth Pharmaceuticals.

Individual please dismissed

Although the appeal committee dismissed the individual pleas, it agreed that NICE’s Appraisal Committee should take another look at the use of a second anti-TNF agent when the first has failed.

The NRAS has welcomed the decision, saying that it is “a relief for many of the 400,000 people who are living with rheumatoid arthritis in the UK,” as some patients find their therapy becomes less effective over time and so benefit from switching to another one.