Rheumatoid arthritis drug approved for the NHS
Publication Date:25/10/2007
Lots of different drugs are used to treat rheumatoid arthritis, but they don't work for everyone. A new rheumatoid arthritis drug has now been approved for use on the NHS, giving people a better chance of finding a helpful treatment if other drugs haven't worked.
What do we know already?
Rheumatoid arthritis is a painful condition that causes stiffness and swelling in your joints. It happens because of a problem with your immune system. Your immune system fights disease by attacking infections in your body, but if you have rheumatoid arthritis, it also attacks healthy tissue in your joints.
There are lots of treatments for rheumatoid arthritis. Many people take ibuprofen or a similar drug to help with pain and swelling. Other drugs can be used to slow down the damage to your joints. Drugs that do this are called disease-modifying drugs.
The newest disease-modifying drugs work by changing the way your immune system works. One group of drugs that do this are called anti-tumour necrosis factor (anti-TNF) drugs.
The three anti-TNF drugs you can get in the UK are called adalimumab (brand name Humira) etanercept (Enbrel) and infliximab (Remicade). Etanercept and infliximab were approved for use on the NHS in 2002. The National Institute for Health and Clinical Excellence (NICE) has now approved adalimumab, and published guidance saying how all three of these drugs should be used.
What does the NICE guidance say?
Adalimumab, etanercept and infliximab are all recommended as treatments for rheumatoid arthritis, but only for people who haven't been helped by at least two other disease-modifying drugs. One of the drugs you'll probably try first is called methotrexate. If your doctor recommends an anti-TNF drug, you'll probably carry on taking methotrexate at the same time.
The guideline also says that people taking an anti-TNF drug should have check-ups every six months to see whether it's helping them. People should stop treatment if the drug doesn't help, or if it stops working.
Anti-TNF drugs are given by injection or by a drip (an IV). You'll need to go for treatment every few weeks. Mild side effects are quite common. And because these drugs affect your immune system, you may have a higher risk of getting serious infections while you're taking them. There's even a chance they could increase your risk of some kinds of cancer. You'll only be offered these drugs by a specialist.
Where does the guidance come from?
NICE is an independent organisation that publishes advice on medical treatments in the UK. It looks at how well treatments work, and whether they offer good value for money to the NHS. Although doctors are free to use their own judgement when treating individual patients, drugs that aren't approved by NICE may be difficult to get on the NHS.
NICE guidelines only apply to England and Wales.
What does this mean for me?
The announcement is good news for people with rheumatoid arthritis. No drug for rheumatoid arthritis helps everyone, so the more treatments we have the better. These drugs offer the chance of an effective treatment to people who find that first-line drugs don't help them.
What should I do now?
If you have rheumatoid arthritis, it's important to find the right combination of drugs that work for you. Not getting the correct treatment can mean you're in pain, and can also mean you get more damage to your joints. If you have rheumatoid arthritis and your treatment isn't helping, make an appointment to see your doctor. Changing the drug or drugs you're taking may help to reduce your symptoms.
From:
National Institute for Health and Clinical Excellence. Adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis. Published online October 2007. Available at: http://guidance.nice.org.uk/TA130 (accessed on 24 October 2007).
To read more, see our information on rheumatoid arthritis.
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© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
