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NICE Negative on Tocilizumab “drastically limits” Treatment Options for Patients with Severe Rheumatoid Arthritis

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This comes only a day after NICE also rejected the use of abatacept for patients who have failed to respond to a first Anti-TNF drug and gave very restricted conditions on the use of three other therapies (adalimumab, etanercept and infliximab).

The combined impact of both NICE’s recommendations come as a bitter blow to patients with very advanced disease. NRAS have condemned this decision that leaves very limited treatment options for people with severe RA.

Ailsa Bosworth, Chief Executive of NRAS said:
“The combined effect of these two NICE decisions this week will be to drastically limit the treatment options for people with severe rheumatoid arthritis. 

“If NICE’s recommendations become final guidance, patients with severe RA who have failed on previous Anti-TNFs will only have access to rituximab in the NHS and only very restricted access to a second Anti-TNF. NICE seem not to understand that RA is not a one size fits all disease. RA patients can react very differently to different treatments. With such limited treatment options, some patients will be left with the unacceptable choices of being put back onto treatments they have already failed on, or taking large doses of steroids which have extremely unacceptable side effects such as osteoporosis when given over the long term.

“These recommendations would deny our most severely ill rheumatoid arthritis sufferers vital steps in their treatment pathway. We simply cannot accept that individuals should be denied the chance of at least regaining some quality of life and condemning them to a life of pain and disability, which could be as or even more expensive to the NHS as well as society as a whole if people, as a consequence of not being able to access clinically effective therapies, lose their jobs.”

Professor David Scott, Consultant Rheumatologist from Norfolk and Norwich University Hospitals and clinical advisor to NRAS said:

“I am very disappointed that NICE have yet again not recommended the use of tocilizumab. It is bad news for patients with severe rheumatoid arthritis who know that there may be a new treatment available to help them when others have failed but that they cannot access it through the NHS.

“For NICE to recommend further Anti-TNFs but not new therapies that have a different mode of action such as tocilizumab will deny some patients a vital life line. This is a truly retrograde step by the Institute that we will be challenging very strongly through the consultation.”