Following a rapid review of a previous appraisal, due to a new patient access scheme, NICE provisionally recommends tocilizumab (RoActemra, Roche) at additional stages in treating rheumatoid arthritis.
From the NICE website:
“In August 2010, NICE issued guidance TA198 to the NHS recommending tocilizumab as an option for people with rheumatoid arthritis if there has 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The [new] draft guidance sets out that in specific clinical circumstances, and only if the manufacturer provides tocilizumab with the discount agreed as part of the patient access scheme, tocilizumab is provisionally recommended as an option for treating rheumatoid arthritis at an earlier point in the treatment pathway. This is where the disease has responded inadequately to disease-modifying anti-rheumatic drugs (DMARDs) and tocilizumab is used as described for other TNF inhibitor treatments in NICE guidance TA130. The draft guidance also includes using tocilizumab as originally recommended in TA198 for people whose disease responded inadequately after both rituximab and TNF inhibitors were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. In all cases this is on the basis that the manufacturer provides tocilizumab with the discount agreed as part of the patient access scheme.”
Two DSU reports were used in the rapid appraisal, with the most recent being produced by Jon Minton, Paul Tappenden and Jonathan Tosh.