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Rituximab, used in conjunction with methotrexate, will now be available on the NHS for eligible people in England and Wales
23 Aug 2007
As edited by Joint-Pain-Forum.com
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
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
'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
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
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.
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