Rheumatoid arthritis - adalimumab, etanercept and infliximab

Summary

This guidance recommends adalimumab, etanercept and infliximab as possible treatments for people with rheumatoid arthritis who:

• have already tried methotrexate and another disease-modifying anti-rheumatic drug (DMARD), and
• have 'active' rheumatoid arthritis, as assessed by a rheumatologist on two separate occasions. People who are treated with adalimumab, etanercept or infliximab should normally also be given methotrexate. If methotrexate does not suit them, they may be given adalimumab or etanercept on its own.

This guidance replaces TA36 'Guidance on the use of etanercept and infliximab for the treatment of rheumatoid arthritis' issued in March 2002. This review and re-appraisal has additionally included adalimumab for the treatment of rheumatoid arthritis, and has taken into account changes in the marketing authorisations for infliximab and etanercept.

Documents

For healthcare professionals

• TA130 Rheumatoid arthritis - adalimumab, etanercept and infliximab: guidance
• TA130 Rheumatoid arthritis - adalimumab, etanercept and infliximab: guidance (MS Word format)
• TA130 Rheumatoid arthritis - adalimumab, etanercept and infliximab: quick reference guide

For patients, carers and the public

• TA130 Rheumatoid arthritis - adalimumab, etanercept and infliximab: understanding NICE guidance
• TA130 Rheumatoid arthritis - adalimumab, etanercept and infliximab: understanding NICE guidance (MS Word format)

Background information

• NICE appraisal of adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis

Implementing this guidance

Any further information NICE has produced to help the NHS implement this guideline locally is linked to below:

• Rheumatoid arthritis - adalimumab, etanercept and infliximab: audit criteria
• Rheumatoid arthritis - adalimumab, etanercept and infliximab: costing statement