NICE anti-TNF ruling a victory for people with rheumatoid arthritis, but Arthritis Care warns more needs to be done

Arthritis Care has today welcomed the landmark decision by the National Institute for Health and Clinical Excellence (NICE) to allow people with rheumatoid arthritis (RA) to switch to a second anti-TNF drug following the failure of a first anti-TNF and then biologic drug rituximab.

Prior to this ruling, people with RA were only allowed to try one anti-TNF drug to slow the progress of their condition.

The charity stressed though that more still needs to be done.

RA, which affects around 700,000 people with RA  in the UK, is a life long, progressive musculoskeletal disease that causes severe pain, swelling and inflammation of the joints. If not treated appropriately, the disease will progress, causing irreversible damage to joints and permanent disability. For some people with the most severe kind of RA, life expectancy is reduced if the disease is left untreated.

Neil Betteridge, chief executive of Arthritis Care, says: ‘This is a positive outcome as Arthritis Care has campaigned extensively to ensure that people with arthritis have fair access to treatments. The decision gives people with RA greater choice by allowing them to try more than one biologic drug, and it will also ensure that this type of drug is more readily available for clinicians to prescribe to their patients.

‘However, Arthritis Care would like to see this go a step further so that clinicians can prescribe what they believe is the most appropriate treatment for their patients. This would also mean that patients would be able play a key role in informed decision-making matters affecting their health.

‘Anti-TNFs are a family of drugs, not all of which have the same outcomes for people with RA. What works well for one individual may not work for another. There is good evidence to show that sometimes people need to switch from one treatment to another, at comparable costs, to find one which is effective. So whilst it is great news for people with RA, we should also be mindful that clinician and patient choice should be the determinant across all the treatment options, including moving from one anti-TNF to another when appropriate.’

‘People with RA don’t seek to change treatment on a whim; they do so when it’s not working for them, in the hope of finding one that does. NICE’s decision will bring hope to many people with arthritis.’

A recent survey on pain by Arthritis Care revealed that of the majority of people with some form of arthritis are living in severe, constant and unmanaged pain, with over half of respondents (57%) saying that their pain would have to be ‘unbearable’ for them to seek help from their doctor or specialist.

Danèlle, 17, anti-TNF recipient

Danèlle says: ‘I have had juvenile idiopathic arthritis since I was three years old. Among the long list of medication I have taken over the years is anti-TNF therapy – the wonder drug as I call it – which I started on whenI was 10 years old.

‘After taking ant-TNF drugs, my life has been transformed. I still have the odd flare up of symptoms but I’ve now got a proper quality of life which is something I didn’t have. Before that I lived in constant pain and a wheelchair was my only real aid to mobility.

‘I’ve been on three different variations of the drug as some stopped working after about a year or so – I think my body just got used to them. I’ve come full circle and am back on the first one I was prescribed, and it seems to be working better than ever the second time around.’

Find out more

• See our factsheet on biologic drugs 
• Information about rheumatoid arthritis

Information and support is available from our free Helpline. Call freephone 0808 800 4050 or email Helplines@arthritiscare.org.uk