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National Institute for Health and Clinical Excellence (NICE)
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NICE consults on draft guidance recommending treatments for types of arthritis that affect the spine
NICE has yesterday published draft guidance on adalimumab (Humira, AbbVie), etanercept (Enbrel, Pfizer), infliximab (Remicade, Merck Sharp & Dohme; Inflectra, Hospira; Remsima, Celltrion), certolizumab pegol (Cimzia, UCB Pharma) and golimumab (Simponi, Merck Sharp & Dohme) – known as TNF-alpha inhibitors – for treating some types of inflammatory arthritis that affect the spine.
The draft guidance re-affirms previous NICE guidance1 recommending adalimumab, etanercept and golimumab2 as treatment options for adults with ankylosing spondylitis. The draft guidance also now recommends certolizumab pegol as an additional treatment option for adults with anklylosing spondylitis.
Non-radiographic axial spondyloarthritis is also covered by the draft guidance and adalimumab, certolizumab pegol and etanercept are provisionally recommended as treatment options for adults with this condition.
Ankylosing spondylitis and axial spondyloarthritis are part of a group of clinically diverse inflammatory rheumatologic diseases known as spondyloarthritis. They cause inflammation mainly in the lower spine, which results in back pain and stiffness. Inflammation at the sites where ligaments and tendons attach to bone can lead to new bone development and joint fixation (ankylosis), where joints and bones fuse together. Disease is classified as ankylosing spondylitis if changes to the sacroiliac joints3 or the spine, or both, can be seen on X-ray. Where there is no X‑ray evidence of the disease, it is classified as non-radiographic axial spondyloarthritis.
Professor Carole Longson, Health Technology Evaluation Centre Director at NICE, said: “Both these conditions are progressive and irreversible and can cause people with them a great deal of pain and discomfort and have a significant negative impact on quality of life.
“We are therefore pleased to be able to add certolizumab pegol to the list of clinically and cost effective treatment options for adults with ankylosing spondylitis, as well as recommending for the first time, treatment options for adults with non-radiographic axial spondyloarthritis.”
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