ProNurse

By Oona Mashta

A costly new drug to treat severe rheumatoid arthritis is now available on the NHS after the manufacturer agreed to pay for the first 12 weeks of treatment – effectively allowing patients to try before they buy.

The first new drug for RA in more than a decade, Cimzia is one of a class of drugs called anti-TNFs, which are highly effective in easing the pain and swelling caused by the disease. But they are expensive, costing £10,000 to £15,000 a year, leading health chiefs to limit prescribing.

The National Institute for Health and Clinical Excellence (NICE), who provide guidelines for medics, originally said last October it would not recommend Cimzia. But it has now approved the drug after the Belgian-based pharmaceutical company UCB agreed to pay the initial treatment costs of £3,575, regardless of whether or not a patient responds to it.

The novel deal, which is set to revolutionise the treatment of RA, was agreed between the pharmaceutical company and the Department of Health through what is called a patient access scheme, whereby manufacturers can contribute towards a costly treatment. If patients continue on the treatment, it will cost the NHS about £14,300 a year.

There are around 350,000 RA sufferers in the UK. An estimated 40,000 of those suffer so severely it affects their ability to work and can cause permanent deformity of the joints. The progressively debilitating condition usually develops between the ages of 25 and 50 and it affects twice as many women as men.

RA occurs when the body’s immune system attacks tissue around healthy joints, which swell and become painful. Despite extensive study, doctors do not know why it happens, although genetics are thought to play a role. It can occur in any joints, but particularly the fingers, hands and feet. In severe cases it can also cause organ damage, affecting the lining of the heart and lungs.

Anti-TNF therapy, a revolutionary family of drug treatments, was introduced in 2000 and has drastically changed the lives of rheumatoid arthritis sufferers worldwide. These medicines have proved effective in the ten per cent of patients who fail to respond to standard therapies, namely non-steroidal anti-inflammatory drugs such as aspirin and ibuprofen, and disease-modifying antirheumatic drugs for more severe cases, which work by suppressing the immune system.

The most common of these is methotrexate, which is also used as chemotherapy.

Anti-TNFs have been shown to reduce the damage of the disease and in some cases put the patient into remission. Studies have found around three-quarters of patients who do not respond to diseasemodifying anti-rheumatic drugs respond well to anti-TNF therapy.

The drugs work by switching off a chemical enzyme called tumour necrosis factor, which plays an important role in causing inflammation and tissue damage in rheumatoid arthritis sufferers.

In an international clinical trial of Cimzia involving 1,601 patients, 80 per cent on the new drug responded to it, although there are four drugs currently available.

The new deal will effectively allow all patients to try two, one of them being Cimzia. Dr Richard Hull, consultant rheumatologist at Queen Alexandra Hospital, Portsmouth, said: ‘This is the first such deal in the field of rheumatic drugs which can be very costly but can be life changing.

Because a patient doesn’t respond to one TNF inhibitor, it doesn’t mean they won’t respond to another.’

www.arthritiscare.org.uk

Originally published by By Oona Mashta.

© 2010 Mail on Sunday; London (UK). Provided by ProQuest LLC. All rights Reserved.

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