NICE reviews guidance on biologics in rheumatoid arthritis

NICE has published new recommendations on the use of biologics in rheumatoid arthritis (RA) replacing previous guidance on adalimumab, etanercept, infliximab, certolizumab pegol, golimumab (for methotrexate-naive RA) and abatacept (after the failure of DMARDs).

The guidance on infliximab covers the new biosimilar versions of the antibody, Inflectra and Remsima, as well as the originator product, Remicade.

There have also been partial updates to guidance on the use of tocilizumab (TA247), and on the use of golimumab after failure of DMARDs (TA225).

All seven biologics can now be prescribed on the NHS when:

  • there is severe RA with a disease activity score (DAS28) of more than 5.1
  • there has been a lack of response to intensive therapy with a combination of conventional DMARDs
  • the manufacturers provide certolizumab pegol, golimumab, abatacept and tocilizumab as agreed in the patient access schemes.

Further information
NICE technology appraisal TA375

Like adalimumab, etanercept and certolizumab pegol, tocilizumab can now be used as monotherapy when use of methotrexate is contraindicated or when a patient is intolerant.

NICE still recommends that treatment be withdrawn if a moderate response (according to EULAR criteria) is not maintained at 6-monthly reviews.

MIMS Clinics

Prescribing news and resources for key therapeutic areas, collated by the MIMS editors.

Register or Subscribe to MIMS

GPs can get MIMS print & online and GPonline for free when they register online – take 2 minutes, and make sure you get your free MIMS access! If you're not a GP, you can subscribe to MIMS for full access.

Register or subscribe

MIMS bulletins

News and updates straight to your inbox.

Prescribing Update: Fortnightly news bulletin
Urgent prescribing updates
Spotlight: Disease-themed monthly round-up

Sign me up

MIMS Dermatology

Read the latest issue online exclusively on MIMS Learning.

Read MIMS Dermatology

Mobile apps

MIMS: access the full drug database and quick-reference tables on the go

MIMS Diagnosis and Management: concise information on signs and symptoms, investigations and diseases

Promo Image

Clinical calculators

Handy calculators and conversions for primary care.