Roche’s RoActemra (tocilizumab) has been provisionally recommended in draft guidance to treat additional stages of rheumatoid arthritis after a rapid review of an earlier appraisal.
RoActemra was originally recommended at a later stage of the treatment pathway, but NICE has now issued new guidance of TA198 fter Roche agreed a Patient Access Scheme with the DH.
Professor Carole Longson, Director of the Health Technology Evaluation Centre at NICE, says the provisional guidance widens the choice of treatments for patients.
A rapid review can be conducted by NICE if a new Patient Access Scheme is submitted within 16 weeks of original guidance publication. However, these schemes can only be considered by NICE after ministerial approval and confirmation by the DH.
In August 2010, NICE issued guidance TA198 recommending RoActemra as an option if there had been an inadequate response to one or more TNF inhibitors and where rituximab has also produced an inadequate response, or where it is contraindicated or has produced undesirable side effects.
The new draft guidance outlines that in specific clinical circumstances – and within the terms of the Patient Access Scheme – it’s recommended where the disease has responded inadequately to disease-modifying anti-rheumatic drugs (DMARDs) and the medication is used as described for other TNF inhibitor treatments in NICE guidance TA130.
The updated guidance also includes using the treatment as originally recommended after both rituximab and TNF inhibitors were tried, and a recommendation on using tocilizumab when rituximab can’t be used after TNF inhibitor treatment has failed.
“If TNF inhibitor treatments have failed and patients are unable to take rituximab, the guidance also provisionally recommends that tocilizumab could be a treatment option at this point, potentially widening the choice of treatments available,” said Professor Longson.