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Tocilizumab for the Treatment of Rheumatoid Arthritis (TA247)

Technology Appraisal Guidance No. 247

Source: National Institute for Health and Care Excellence

NOTE: This guidance replaces ‘NICE technology appraisal guidance 198’ issued in August 2010.

1. Guidance

1.1  Tocilizumab in combination with methotrexate is recommended as an option for the treatment of rheumatoid arthritis in adults if:

  • the disease has responded inadequately to disease-modifying anti-rheumatic drugs (DMARDs) and it is used as described for tumour necrosis factor (TNF) inhibitor treatments in Adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis (NICE technology appraisal guidance 130), specifically the recommendations on disease activity and choice of treatment or
  • the disease has responded inadequately to DMARDs and a TNF inhibitor and the person cannot receive rituximab because of a contraindication to rituximab, or because rituximab is withdrawn because of an adverse event, and tocilizumab is used as described for TNF inhibitor treatments in Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a TNF inhibitor (NICE technology appraisal guidance 195), specifically the recommendations on disease activity or
  • the disease has responded inadequately to one or more TNF inhibitor treatments and to rituximab
  • and the manufacturer provides tocilizumab with the discount agreed as part of the patient access scheme.

1.2  People currently receiving tocilizumab for the treatment of rheumatoid arthritis who do not meet the criteria in 1.1 should have the option to continue treatment until they and their clinicians consider it appropriate to stop.


The guidance shown above constitutes Section 1 of the full document. A copy of the full document and a summary of the evidence is available on the Internet at http://guidance.nice.org.uk/TA247

This guidance represents the view of the Institute which was arrived at after careful consideration of the available evidence. Health professionals are expected to fully take it into account when exercising their clinical judgement. This guidance does not, however, override the individual responsibility of health professionals to make appropriate decisions in the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.

© Copyright National Institute for Health and Care Excellence. All rights reserved. This material may be freely reproduced for educational and not for profit purposes within the NHS. No reproduction by or for commercial organisations is permitted without the express written permission of the Institute.

Enquiries concerning the guidance should be addressed to: National Institute for Health and Care Excellence, MidCity Place, 71 High Holborn, London WC1V 6NA. email:nice@nice.org.uk

Tocilizumab for the treatment of rheumatoid arthritis (rapid review of technology appraisal guidance 198).
Issue Date: February 2012

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