NICE recommends additional biologicals for rheumatoid arthritis

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The National Institute for Health and Care Excellence (NICE), which publishes clinical guidance for England, has recommended the use of new biological drugs for the treatment of moderate rheumatoid arthritis. The treatments have become available thanks to biosimilars, which have drastically reduced costs to the National Health Service (NHS) in England.

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On 10 June 2021, NICE published guidance recommending additional treatment options for rheumatoid arthritis, an increasingly common inflammatory condition that causes swollen and painful joints. It affects around 400,000 people in the UK.

The guidance provides new treatment options for patients with moderate rheumatoid arthritis who have not responded to conventional therapies. This includes around 25,000 people in England.

The guidance recommends the use of adalimumab, etanercept and infliximab, taken together with methotrexate, for use in the NHS. Adalimumab and etanercept can also be taken on their own if methotrexate is contraindicated or not tolerated by the patient.

However, the drugs are only recommended for use in moderate disease if intensive treatment with at least two conventional disease-modifying antirheumatic drugs (DMARDs) has not been successful.

This change in guidance is due to the increasing availability of biosimilar versions of these drugs, which have drastically reduced costs to the NHS. Previously, biological treatments were only recommended by NICE for severe forms of rheumatoid arthritis.

Meindert Boysen, Deputy Chief Executive and Director of the Centre for Health Technology Evaluation at NICE, said he was delighted to recommend the additional treatment options: ‘These recommendations come after a pragmatic review of existing guidance in response to the availability of biosimilars in the NHS. We are pleased that the introduction of biosimilars has lowered overall costs of treatment, allowing our independent committee to recommend biological treatment for more people with rheumatoid arthritis so they can enjoy a better quality of life’, he added.

A recent review and meta-analysis of biosimilars for the treatment of rheumatoid arthritis [1] provided evidence for the efficacy and safety of biosimilars for the disease, compared with reference biological DMARDs (bDMARDs).

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1. GaBI Online - Generics and Biosimilars Initiative. Review and meta-analysis of biosimilars for the treatment of rheumatoid arthritis []. Mol, Belgium: Pro Pharma Communications International; [cited 2021 Jul 2]. Available from:

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Source: NICE

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