Health Watchdog Decision A 'triumph', Says Arthritis Care, As England & Wales Follow Scotland

Main Category: Arthritis / Rheumatology
Article Date: 23 Aug 2007 - 15:00 PDT

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Thousands of adults with severe rheumatoid arthritis may now have their hopes of returning to full social and working life realised, thanks to a NICE decision hailed as a 'triumph' by the leading arthritis-voice organisation.

The National Institute for Health and Clinical Excellence yesterday 22nd August 2007 announced its long-awaited guidance that doctors can prescribe rituximab (MabThera) as a new NHS option for eligible adults with RA for whom anti-TNF therapy has not proved effective.

This final decision means that rituximab, used in conjunction with methotrexate, will now be available on the NHS for eligible people in England and Wales, who either cannot tolerate TNF blockers or have not shown improvement with one or more such drugs.

'It's a triumph. The search for effective treatment can be a long, agonising journey, littered with dashed hopes. Now there's no excuse for denying this drug on any grounds but clinical', said Arthritis Care's chief executive Neil Betteridge, who has had RA since the age of three.

'NICE is bound to balance cost against benefit. This decision shows that it understands the benefit of expanding the range of choices for individuals who have exhausted other options, and would otherwise face the bleak prospect of palliative care, and a return to drugs that have already failed them', he said. 'Anti-TNF therapies don't work for everyone. Left untreated, the disease can be severely disabling, so pinpointing the right drug is a race against time. In matching a given individual to what's most suitable, the more options there are, the better'.

Rituximab is already available in Scotland in accordance with a decision by NICE's counterpart north of the border, the Scottish Medicines Consortium, whilst Northern Ireland usually follows NICE's guidance.

Over 400,000 Britons have rheumatoid arthritis, an inflammatory disease in which the immune system does not protect the body, but attacks it instead. It is not clear what causes rheumatoid arthritis and there is no cure at present. About 10% (40,000) of the people with RA have the most severe form of the condition and it is individuals within this 40,000-strong group who may benefit from today's decision.

(1) Rheumatoid arthritis appears to be caused in the body by a chemical agent called a cytokine, known as a TNF-alpha. A group of drugs called biologic agents - anti-TNFs, TNF blockers or TNF inhibitors - were developed to block the cytokine and neutralise its activity.

To qualify for anti-TNF treatment, people with severe rheumatoid arthritis must be prescribed it by a consultant rheumatologist. They must already have failed to respond well to at least two of the cheaper, disease-modifying anti-rheumatic drugs (DMARDS), including methotrexate.

Arthritis is the UK's biggest single cause of physical disability, affecting around nine million people. Rheumatoid arthritis is the commonest form of inflammatory arthritis in Britain, affecting some 400,000 people. Its precise cause is unknown, and still being researched, but it is regarded as a kind of autoimmune disease. It can occur at any age and is characterised by persistent inflammation of many joints. 75% of those with rheumatoid arthritis are women.

(2) Arthritis Care, which was established in 1947, is the UK's largest voluntary organisation committed to supporting all people with arthritis in any one of its some 200 forms. It is 60 this year and is celebrating its Diamond Jubilee with events throughout 2007.

It works to represent people with arthritis and to lobby decision-makers on their behalf. It has over 300 branches UK-wide, and offers arthritis awareness courses and self-management training. In addition, it provides a free helpline service, and produces a range of information booklets, plus the award-winning Arthritis News. It campaigns both locally and nationally for people with arthritis.

http://www.arthritiscare.org.uk