The Scottish Medicine’s Consortium has recommended the use of Schering-Plough’s Remicade (infliximab) for the treatment of ankylosing spondylitis, a severely disabling rheumatic disease affecting up to 1 in 200 of the population.

The SMC is the first advisory consortium in the UK to recommend the use of an anti-tumour necrosis factor-based therapy for AS, although the announcement comes more than two years after Remicade first gained regulatory clearance for this indication in Europe [[22/05/03e]]. This further highlights the substantial time lag that can occur from a drug’s approval to its full use in UK hospitals, during which time scores of patients are not receiving the best treatment available.

Commenting on the SMC’s endorsement, Fergus Rogers, director of the National Ankylosing Spondylitis Society, said: “Anti-TNF drugs are a crucial resource for people with AS because the treatment is used when other approaches fail – and the benefits can be fantastic.” He added that, in real terms, “the SMC’s decision means more choices for the 5,000 or so people with AS in Scotland. I hope this is the beginning of a change across the UK, and that we’ll see this treatment being made available to people with AS in England, Wales and Northern Ireland.”

AS is a chronic and debilitating condition, which leads to stiffening and subsequent fusion of the spine. The severity of long-term symptoms can dramatically impact the day-to-day lives of patients and this, in turn, can have a significant effect on the economy. A study conducted by Arthritis Research Campaign in 1999-2000 discovered that 1.4 million working days were lost to AS annually in the UK alone, which translates to around £122 million lost in production, the firm notes.

Remicade works by reducing inflammation as well as joint and tissue damage by blocking the action of TNF, which is believed to play a major role in the process. The drug has a wide-ranging efficacy, as is shown by the variety of indications it is approved for, such as Crohn’s disease, rheumatoid arthritis, ulcerative colitis, psoriasis and psoriatic arthritis. In 2004, Remicade generated sales of some $2.15 billion for Schering-Plough, helping the firm’s turnaround in financial performance following a few torrid years.