National Institute for Health and Clinical Excellence (NICE)
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NICE draft guidance recommends treatments for types of arthritis that affect the spine
In final draft guidance published recently NICE has recommended adalimumab (Humira, AbbVie), etanercept (Enbrel, Pfizer), infliximab (Remicade, Merck Sharp & Dohme; Inflectra, Hospira; Remsima, Napp Pharmaceuticals)1, certolizumab pegol (Cimzia, UCB Pharma) and golimumab (Simponi, Merck Sharp & Dohme) 2 – known as TNF-alpha inhibitors – for treating some types of inflammatory arthritis that affect the spine.
As well as re-affirming previous NICE guidance3 recommending adalimumab, etanercept and golimumab as treatment options for adults with ankylosing spondylitis, the draft guidance also now recommends infliximab and certolizumab pegol as additional treatment options for adults with anklylosing spondylitis.
Non-radiographic axial spondyloarthritis is also covered by the draft guidance and adalimumab, certolizumab pegol and etanercept are provisionally recommended as treatment options for adults with this condition.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 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 joints4or 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.
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