Arthritis Care welcomes NICE approval for new RA drug but calls for greater access to all existing RA drugs

Arthritis Care welcomed guidance from NICE (the National Institute for Health and Clinical Excellence) on 21 January 2010 sanctioning the use of the new rheumatoid arthritis (RA) drug certolizumab pegol (Cimzia) on the NHS in England, Wales and Northern Ireland.

But the charity also urged NICE to ensure access to the fullest range of effective RA drugs for all who need them.

The new drug, certolizumab pegol, is to be used for people with severe active RA for whom first-line treatment with disease-modifying anti-rheumatic drugs (DMARDs) has failed. Certolizumab pegol adds an alternative to the existing three anti-TNF (Tumour Necrosis Factor alpha) drugs currently available through the NHS.

As long as no appeal is made to NICE’s draft guidance on certolizumab pegol, final guidance to the NHS is expected to be issued within weeks. A Scottish Medical Consortium decision about use of certolizumab pegol in Scotland is expected in the spring.

Arthritis Care chief executive and vice president of the European League against Rheumatism (EULAR), Neil Betteridge, said: ‘We very much welcome the decision to add certolizumab pegol to the existing range of anti-TNF treatments available to people with RA who have been failed by first line treatment.

'If left untreated RA can be an intensely painful, debilitating disease forcing people out of work – and in the most severe cases, can even lead to death. It’s vital that early diagnosis is made and appropriate treatment given to ensure the best chance of keeping this disabling disease under control.'

At present, sequential use of anti-TNFs is not allowed on the NHS. Despite the availability of three anti-TNF drugs, if patients are failed by one, their only option is to use a different form of drug. NICE is currently reviewing sequential use of anti-TNFs and Arthritis Care would like to see a green light result.

Mr Betteridge said: ‘There is a good deal of evidence that where one anti-TNF does not work, another may be very effective. Each treatment works in a different way, so for some people one will be much more effective than another, but it is difficult to know which will be best before treatment begins.

The addition of another anti-TNF to the RA treatment arsenal is even further reason for NICE to revise its current position and allow people with RA to try as many anti-TNFs as they need until they find one that works for them. Having access to the widest range of treatment options gives someone with RA the best chance of stopping this condition in its tracks.

'Arthritis Care is pressing the Department of Health in England to appoint a National Clinical Director, or 'tsar', whose role would primarily be to ensure better co-ordination of musculoskeletal services. NICE's current concerns about cost effectiveness in relation to sequential use would in this way be looked at in a more detailed and strategic way, benefiting all parties’.

If you would like to talk to someone about your arthritis, call the Arthritis Care Helpline on freephone 0808 800 4050 Monday – Friday (10am - 4pm) for confidential practical and emotional support. If you have RA and think this treatment may be of benefit to you, you should seek advice from your rheumatologist.

For more information

• read NICE’s full guidance on certolizumab pegol
• find out more about rheumatoid arthritis