NICE rejects TNF-a drugs for ulcerative colitis

Three drugs in the TNF-alpha blocker class have been rejected by NICE on cost and clinical effectiveness grounds compared to existing treatments.

England's National Institute for Health and Care Excellence (NICE) says in draft guidance that Merck Sharpe & Dohme's Remicade (infliximab) AbbVie's Humira (adalimumab) and Merck Sharpe & Dohme's Simponi (golimumab) should not be used in the NHS to treat moderate to severe ulcerative colitis.

An estimated 146,000 people in the UK live with ulcerative colitis, a chronic condition in which the large intestine becomes inflamed. Symptoms vary, but may include bloody diarrhoea, abdominal pain, weight loss, fatigue and an urgent need to go to the toilet.

Professor Carole Longson, NICE Health Technology Evaluation Centre Director, said: "The independent committee concluded that there is currently not enough evidence to prove that infliximab, adalimumab and golimumab is clinically and cost effective compared with other treatments currently available to ulcerative colitis patients on the NHS.

"NICE has now opened a consultation on the draft guideline for infliximab, adalimumab and golimumab, and welcomes the manufacturer and stakeholders to comment on the recommendations and if possible provide more information which could potentially enable NICE to make more positive recommendations."

All three drugs are all licensed to treat moderate to severely active ulcerative colitis in adults who have had an inadequate response to conventional therapy, or are unable to take such treatments. Remicade is also licensed to treat children and adolescents aged 6-17 years.

The companies, healthcare professionals and members of the public are now able to comment on the preliminary recommendations which are available for public consultation until Wednesday 15 October 2014.

Final guidance is expected to be published January 2015. Until then, NHS bodies are advised, as usual, to make decisions locally on the funding of specific treatments.