NICE has recommended golimumab (Simponi), in combination with methotrexate, as another option for the treatment of active rheumatoid arthritis. Like other tumour necrosis factor (TNF) inhibitors, it can be considered for use in patients with:
- a disease activity score greater than 5.1 on two separate occasions at least 1 month apart, who have undergone trials of two conventional DMARDs, including methotrexate (unless contraindicated), or
- severe rheumatoid arthritis, who have inadequately responded to other DMARDs, including at least one TNF inhibitor, and for whom rituximab is inappropriate.
NICE approval of golimumab is contingent on the manufacturer supplying the 100mg dose, which should be considered for use in patients >100kg, at the same price as the 50mg dose.