New Medicine Report. Anakinra Classification RED (Adopted by the CCG until review and further notice) Date of Last Revision 5 th July 2002
|
|
- Augusta Goodman
- 5 years ago
- Views:
Transcription
1 New Medicine Report Document Status Anakinra Classification RED (Adopted by the CCG until review and further notice) Post Suffolk D&TC Date of Last Revision 5 th July 2002 Approved Name Trade Name Manufacturer Legal Status Indication Dosage Cost Possible Number of Suffolk Patients Number Needed to Treat Treatment Alternatives (NB Costs quoted are just for the medication and exclude the nursing administration costs) Future Alternatives Possible Future Indications Anakinra Kineret Amgen POM Licensed Treatment of the signs and symptoms of rheumatoid arthritis in combination with methotrexate in patients with an inadequate response to methotrexate alone Adults - 100mg in 0.67ml once daily by subcutaneous injection at the same time each day <18 years of age - not recommended for 28 syringes 7,450 per year Estimated prevalence of 1% - 6,700 Estimated incidence of 0.04% Suggested number in the region of 8 per 100,000 In the region of 6 over a 24 week period See text for details Etanercept 25mg s/c twice weekly 7,500/year Infliximab 3mg/kg IV 7,500/year Leflunomide 20mg once daily 560/year Sulphasalazine EC 500mg qds 140/year Methotrexate oral 10mg weekly 29/year Methotrexate IM 1 weekly 700/year Penicillamine 250mg bd 114/year Gold 50mg IM monthly 118/year Ciclosporin (200mg Neoral daily) 1832/year Possible joint use with one of the TNFinhibitors Asthma, diabetes, GVHD, IBS, 1 Price through Specials Manufacture
2 leukaemia, psoriasis
3 Reviewer s Comments Anakinra is a novel approach to the treatment of rheumatoid arthritis. There is some evidence of its action which suggests an NNT compared with placebo for an ACR50 at 24 weeks to be in the region of 6. Further long-term evidence will be required to confirm the possibility of the medication reducing the progression of the disease. Similar long term evidence will be required to ensure that the side effect profile is no worse than currently suggested and that it has no deleterious effect on the progress of the disease. I am concerned that the NNTs produced from the available information seem to suggest that the response is dose related. It can be seen in Table 3 that as the dose moves from 0.4mg/kg to 1.0mg/kg the NNT improves but that it worsens as the dose moves to 2.0mg/kg for all ACR results at 24 weeks. The significance of this is not clear but it is possible that there are two mechanisms in balance (see remark re Arend et al pg 5) which are being affected. If this is so then it would seem that the dose given may be a critical factor in achieving the desired outcome. It should be noted that neither of the trials used the standardised dose (100mg) that is now available thus the dose/kg will vary from patient to patient and is unlikely to reflect the dose given during the trials. The data sheet states that anakinra should be initiated and supervised by specialist physicians experienced in the diagnosis and treatment of rheumatoid arthritis. This would suggest that the product should initially be placed in the red (consultant only) section of the Suffolk Drug & Therapeutics Traffic Light document. It is suggested that patients should only be offered treatment with this agent in line with the British Association of Rheumatologists guidelines for the use of other biologic agents e.g. inhibitors. Evidence Reviewed Paper, Review, Abstract etc. Bresnihan B, Alvaro-Gracia JM, Cobby M et al. Treatment of rheumatoid arthritis with recombinant human interleukin-1 receptor antagonist. Arthritis & Rheumatism Vol 41 No 12 December Jiang Y, Genant IW, Cobby M et al. A multicenter, double-blind, dose-ranging, randomised, placebocontrolled study of recombinant human interleukin-1 receptor antagonist in patients with rheumatoid arthritis. Arthritis & Rheumatism Vol 44 No 5 May Level of evidence I I
4 Cunnane G, Madigan A, Murphy E, et al. The effects of treatment with interleukin-1 receptor antagonist on the inflamed synovial membrane in rheumatoid arthritis. Rheumatology 2001;40:62-69 Cohen S, Hurd E, Cush J, et al. Treatment of rheumatoid arthritis with anakinra a recombinant human interleukin-1 receptor antagonist in combination with methotrexate Arthritis & Rheumatism Vol 46(3), March 2002: Arend WP, Dayer JM. Cytokines and cytokine inhibitors or antagonists in rheumatoid arthritis. Arthritis and Rheumatism 1990;33(3): American College of Rheumatology. Guidelines for the management of Rheumatoid Arthritis. Arthritis & Rheumatism;46(2) February 2002: Anakinra Advanced Evaluated Information. UKMi June 2001 Monograph 3/01/02 Level of evidence adapted from Quick and Clean : authorative health technology assessment for local health care contracting Andrew Stevens, Duncan Collin-Jones & John Gabbay Health Trends Vol 27 No Assessment Tools American College of Rheumatology classification of functional status in RA I I IV III III Class I II III IV Criteria a Able to perform usual activities of daily living (self-care, vocational and avocational) Able to perform self-care and vocational activities but limited in avocational activities Able to perform self-care activities, but limited in vocational and avocational activities Limited in ability to perform self-care, vocational and avocational activities a Self-care activities include dressing, feeding, bathing, grooming and toileting; vocational activities include work, educational and/or homemaking activities; avocational activities include recreational and/or leisure activities. American College of Rheumatology (ACR) core set of disease activity measures in RA Area of disease activity Swollen joints Tender joints Patient s assessment of pain Physician s assessment of disease status Patient s assessment of disease status Measure Based on assessment of 28 joints Based on assessment of 28 joints Assessed with a 10cm visual analogue scale Assessed with a 10cm visual analogue scale Assessed with a 10cm visual analogue scale
5 Acute phase reactant (either ESR of C- reactive protein level) Clinically significant improvement is defined as a 20% reduction in the number of swollen joints, a 20 % reduction in the number of tender joints, plus a 20% improvement in 3 of the 5 remaining criteria. Additional ACR points are defined at 50% or 70% using the same measures. There is a widely held view that ACR50, rather than ACR20, should be taken as the clinically significant marker with ACR70 being taken as an exceptional result. Review Rheumatoid arthritis (RA) is a progressive disease associated with severe morbidity, functional decline, permanent disability and an increase in mortality. Patients are at high risk of developing joint erosions. Disease progression is rapid in the early phases and thus there has been a trend to treat the disease aggressively with disease modifying anti-rheumatic drugs (DMARDs). Whilst there would appear to be consistent use of DMARDs in patients with moderate or long standing RA few have been shown to retard disease progression, although sulphasalazine has shown this effect. DMARDs can rarely be given for long periods in RA because of their lack of sustained efficacy and the associated toxicity. In patients who fail to respond to DMARD mono-therapy combinations of drugs, usually methotrexate plus another DMARD, are often used. In RA an excessive (pathological) inflammatory response within the synovium, as well as other tissues, leads to damage. Tumour Necrosing Factor alpha (TNFα) is a cytokine released by cells within the immune system when inflammation occurs. It plays a rôle in the initiation and maintenance of the immune response. TNFα induces activation of T and B lymphocytes and increases the production of cyclo-oxygenase-2 (COX-2) which synthesizes further pro-inflammatory factors. High levels of TNFα are found in the blood of patients with RA and the level of TNFα in the synovium correlates with joint disease activity. The levels of soluble TNFα receptors are increased in the blood and joint fluid of patients with RA. Reduction in the activity of TNFα by various experimental mechanisms has been shown to lead to a decrease in disease activity. Two biologic products, etanercept and infliximab have been developed to block TNFα.
6 A separate pro-inflamatory cytokine, interleukin-1 (IL-1), is known as a central mediator in RA. Patients with RA will show an elevated level of IL-1 in the synovial fluid. Patients with erosive RA have higher synovial and circulating levels of IL-1 than patients without erosions. Anakinra is a recombinant form of naturally occurring IL-1 receptor antagonist (IL-1Ra) with an identical mode of action. It blocks the biological activity of IL-1 via competitive inhibition of the binding of IL-1 to the IL-1 type 1 receptor (IL- 1RI). It should be noted that a full understanding of the actions of cytokines and cytokine inhibitors is still being developed. Arend and Dayer have suggested that IL-1 may, in addition to its inflammatory activity, have anti-inflammatory effects, such as the induction of the synthesis of collagen and enzyme inhibitors by chondrocytes and synovial fibroblasts. In a trial by Bresnihan 472 patients with active and severe RA with a duration of <8 years were recruited into a 24 week double-blind, randomised, placebocontrolled multicentre study. Non-steroidal anti-inflammatory drugs (NSAIDs) and/or corticosteroid treatment was kept constant throughout the study but DMARDs were discontinued at least 6 weeks before the study commenced. Please note that no patients were receiving methotrexate in this trial. The primary efficacy measure was the ACR score and the results are shown in Table 1. Table 1 To show clinical response to treatment with IL-1Ra according to ACR 20 criteria Dosage (mg/day) n Improved at 24 weeks, number (%) P NNT at 24 weeks compared with placebo (27) 0.020* (39) (34) (43) *placebo group versus combined treatment group In a paper by Cohen 419 patients with moderate to severe active RA who were receiving methotrexate (MTX) for 6 consecutive months with stable doses for 3 months but with disease for no longer than 12 years were randomised into 6 groups. The groups received either placebo or varying doses of anakinra together with their dose of MTX. The primary efficacy end point was measured
7 using the ACR20 response measure. The results are shown in Table 2 with the NNTs shown in Table 3. Table 2 To show the percentages of patients achieving the primary end point ACR20 together with those attaining ACR50 and ACR75 at weeks 12 and 24 Dose of Week 12 Week 24 Anakinra n ACR20 ACR50 ACR75 ACR20 ACR50 ACR75 Placebo mg/kg mg/kg mg/kg mg/kg mg/kg Given an average weight of 75Kg the dose equivalent for 1mg/kg would be 75mg per day and for 2mg/kg it would be 150mg per day, the licensed product is a single dose of 100mg. All patients also on methotrexate Table 3 To show the NNT compared to placebo to achieve the primary end point ACR20 together with ACR50 and ACR75 at weeks 12 and 24 Dose of NNT at Week 12 NNT at Week 24 Anakinra n ACR20 ACR50 ACR75 ACR20 ACR50 ACR75 Placebo mg/kg mg/kg mg/kg mg/kg mg/kg Given an average weight of 75Kg the dose equivalent for 1mg/kg would be 75mg per day and for 2mg/kg it would be 150mg per day, the licensed product is a single dose of 100mg. All patients also on methotrexate Adverse Effects etc. For full information please see the SOPC. The safety of anakinra is based on an integrated database of 2606 patients including 570 who have been prescribed the medication for more than one year. The SOPC gives the following information (Table 4) on very common and common side effects. Table 4 To show the incidence of very common and common side effects for anakinra
8 Frequency Body system Undesirable effect Very common (>10%) Skin and subcutaneous tissue disorders Nervous system disorders Injection site reaction Headache Common (1%-10%) Blood and lymphatic system disorders Infections and infestations Neutropenia Serious infections requiring hospitalisation The incidence of serious infection was higher in anakinra patients than in patients receiving placebo (1.8% versus 0.7%). These infections consisted mainly of bacterial events such as cellulitis, pneumonia and bone and joint infections. There are no adequate data to support the use of anakinra in pregnant women. Anti 1L-Ra antibodies have been detected in three patients with neutropenia although no neutralising antibodies have been detected. The ACR suggests that, in common with other biologic therapies, there is concern about the risk of serious infections and malignancy but the safety data are limited. Patients with asthma/chronic obstructive pulmonary disease had a higher rate of pulmonary infections in trials; thus anakinra should be used with caution in patients with these comorbid conditions. They suggest that anakinra should not be given to patients with active infections of any type. Health Economics RA affects about 1% of adults in the UK with around 10% of these progressing to a severe form of RA. Many of these patients will be adequately treated with current medications, however some will not. If the uptake of this new agent is similar to that of TNF-inhibitors then it is likely that about 8 patients per 100,000 population may be suitable for anakinra. Using these figures and an average cost of 7,450 per year then the following table (Table 5) can be constructed. However it is likely that these 8 patients would be the same 8 patients eligible for TNF-inhibitor therapy. Some funding has already been made available for these patients. Thus the increase in budget may be less than the figures suggest. If the products are found to be particularly effective there may, however, be a move in the future to use them at an earlier stage in the treatment cycle thus increasing the costs significantly.
9 Table 5 To show the possible anakinra costs for each PCT in Suffolk PCT Population Expected number Cost ~( ) of patients Central 96, ,600 Ipswich 143, ,950 Suffolk Coastal 99, ,600 Suffolk West 203, ,200 Waveney 114, ,050 Total for Suffolk ,400 Total for East Commissioning 338, ,150 There will be additional costs required for the initial monitoring of patients and they will require some training in the use of the sub-cutaneous injections. In addition all patients will be on other medication. The total cost may be offset by reductions in the costs of managing the progression of the disease. However some of the direct health costs will not be able to be realised as the specialist staff will remain employed although there will be the possibility of their being able to treat other patients. Given the debilitating nature of the disease the social care costs saved could be significant.. Reviewer s Comments 1. Data to support the use of anakinra at the licensed dose of 100mg/day - two key clinical studies have been conducted in which a total of 366 patients with RA received anakinra at the licensed dose of 100mg/day. The first is an ongoing, randomised, double-blind, placebo-controlled study in 906 patients to assess the efficacy and safety of anakinra in combination with methotrexate. The primary endpoint of this study is the impact of anakinra on the progression of radiographic damage, as measured by the Sharp score. However, interim data on the effects of anakinra on the signs and symptoms of rheumatoid arthritis (RA) has been examined for the first 501 patients enrolled onto this study. The results of this analysis indicate that treatment with anakinra plus methotrexate results in significant and sustained improvements in the signs and symptoms of RA compared to methotrexate plus placebo, as measured by the ACR score. These data were presented at the American Society of Rheumatology annual conference last year 1. Results from a second study of anakinra at a dose of 100mg /day were also presented at the same meeting 2. This was a randomised, placebo-controlled
10 safety study designed to prospectively examine the overall safety of anakinra in 1414 patients in the average clinical practice, by including patients receiving a variety of concurrent RA medications including multiple disease modifiying antirheumatic drugs (DMARDs), as well as patients who were DMARD-free. The study population also included patients predisposed to infection due to a history of underlying disease, and patients with a variety of comorbidities. The data from these studies have yet to be published in peer-reviewed journals (data from the efficacy study currently remains blinded to the primary endpoint of radiographic joint damage). However, they were a critical component of our regulatory submissions to both the European Medicines Evaluation Agency and the Food and Drug Administration, and supported the granting of a product licence for anakinra at a dose of 100mg/day in both Europe and the USA. The clinical trial data for both trials can be reviewed in full on http//: [Confirmatory Efficacy Study number , Safety Study number ] Anakinra should be prescribed by consultant rheumatologists, as indicated by your statement: anakinra should be initiated and supervised by specialist physicians experienced in the diagnosis and treatment of RA. Review 1. p5, paragraph 4. The wording could be altered to clarify that: In addition to its inflammatory activity IL-1 has pro-destructive effects, such as the inhibition of the proteoglycan synthesis and the stimulation of collagen breakdown by chondrocytes and synovial fibroblasts p6 Table 2 and associated text. The number of patients achieving ACR70 was calculated, not ACR75 7. Adverse Effects The data presented gives a fair representation of the information contained on the Summary of Product Characteristics. However, additional points could be highlighted given the current interest in the safety of the biological agents with regards to infection. As discussed on page 6 of the submission, the safety of anakinra is based on a safety database of 2606 patients. Of these patients 1414 were included in the prospective study designed to examine the safety profile of anakinra in the average clinical practice (reviewed above 2 ). Patients included in this trial were receiving a variety of concurrent RA medications or no concurrent treatment; were predisposed to infection due to a
11 history of underlying disease such as pneumonia, asthma, controlled diabetes and chronic obstructive pulmonary disease; and had co-morbidities such as hypertension, coronary artery disease and congestive heart failure. Despite the inclusion of these patients, there have been no on-study deaths due to serious infections in clinical trials with anakinra. In addition, there have been no reported cases of tuberculosis or opportunistic infection 3. Health Economics 1. p7 paragraph 3. As stated, we would expect that patients treated with anakinra would be the same patients eligible for TNF-inhibitor therapy. 2. p8 paragraph 1. Costs required for the initial monitoring of patients receiving anakinra would be those associated with the monthly assessment of neutrophil numbers in the first 6 months of treatment, and quarterly thereafter. However, blood count assessment is likely to occur as part of the ongoing monitoring of disease. References: 1. Cohen, SB et al. Anakinra (recombinant interluekin-1 receptor antagonist) : a large, placebocontrolled efficacy trial of anakinra in patients with erosive rheumatoid arthritis disease. Latebreaking abstract-1, American Society of Rheumatology Annual Conference, can be viewed at 2. Fleischmann, R et al. A safety trial of anakinra: Recombinant interleukin-1 receptor antagonist (IL-1Ra) in a large, placebo controlled heterogeneous populations of patients with rheumatoid arthritis. Arthritis and Rheumatism, 2001, supplement, abstract S84 3. Kineret (anakinra) FDA Briefing Information, August 16, 2001: available on: http//: 4. van den Berg, WB. Anti-cytokine therapy in chronic destructive arthritis. Arthritis Research, 2001, 3: Arend, WP. Interleukin-1 receptor antagonist. Advances in Immunology, 1993; 54: Joosten, LA et al. IL-1 alpha beta blockade prevents cartilage and bone destruction in murine type II collagen-induced arthritis, whereas TNF-alpha blockade only ameliorates inflammation. Journal of Immunology, 1999, 163: Cohen SB et al. Treatment of Rheumatoid Arthritis with Anakinra, a Recombinant Human Interleukin-1 Receptor Antagonist, In Combination with Methotrexate. Arthritis and Rheumatism, 2002, 46(3):
12 SUFFOLK DRUG AND THERAPEUTICS COMMITTEE New Drug Bulletin: Anakinra (Kineret TM ) SUFFOLK DRUG AND THERAPEUTICS COMMITTEE RECOMMENDATION: Suffolk Drug and Therapeutics Committee has considered the use of anakinra for rheumatoid arthritis in conjunction with methotrexate and considers that it should be a RED drug, i.e. hospital-only - GPs should not be expected to prescribe it. In addition it should be used only when patients have not responded to etanercept or infliximab, or cannot tolerate these drugs. FURTHER DETAILS Licensed indication: Dosage: Cost: Treatment of the signs and symptoms of rheumatoid arthritis in combination with methotrexate in patients with an inadequate response to methotrexate alone. Adults - 100mg in 0.67ml once daily, by subcutaneous injection at the same time each day <18 years of age - not recommended for 28 syringes 7,450 per year PRESCRIBING COMMENTS FROM THE SUFFOLK DRUG AND THERAPEUTICS COMMITTEE: The numbers needed to treat (NNTs) from trial work on anakinra are not so good as those achieved in trials of etanercept and infliximab, although head to head trials have not taken place. The cost of using anakinra is similar to that of using infliximab or etanercept. Local rheumatologists suggested that anakinra might have a place in the treatment of rheumatoid arthritis if patients were unable to tolerate etanercept or infliximab. Monitoring of the use of anakinra, etanercept and infliximab can be done via hospital pharmacies. Anakinra carries a black triangle in common with all new drugs. All suspected adverse reactions should be reported to the CSM on a yellow card.
13 Paul Berry Prescribing Medical Advisor October 2002 These notes are only intended to provide brief guidance. Please refer to the latest Summary of Product Characteristics (Data Sheet) for full prescribing details.
Bringing the clinical experience with anakinra to the patient
Rheumatology 2003;42(Suppl. 2):ii36 ii40 doi:10.1093/rheumatology/keg331, available online at www.rheumatology.oupjournals.org Bringing the clinical experience with anakinra to the patient S. B. Cohen
More informationNew Medicine Report (Adopted by the CCG until review and further
New Medicine Report (Adopted by the CCG until review and further DEXIBUPROFEN notice) Document Status Decision made at Suffolk D&TC 7 th September 2006 Traffic Light Decision Double Green Prescriber s
More informationGREEN. Ropinirole Other PD treatments Benzodiazepines Opioids low potency Anticonvulsants Clonidine
New Medicine Report (Adopted by the CCG until review and futher notice) Document Status Traffic Light Decision PRAMIPEXOLE For restless legs syndrome Post Suffolk D&TC GREEN Prescribers Rating Possibly
More informationLondon, 1 June 2006 Product name: REMICADE Procedure number: Remicade-H-240-II-73-AR SCIENTIFIC DISCUSSION 1/8
London, 1 June 2006 Product name: REMICADE Procedure number: Remicade-H-240-II-73-AR SCIENTIFIC DISCUSSION 1/8 1. Introduction Infliximab is a chimeric human-murine IgG1κ monoclonal antibody, which binds
More informationScottish Medicines Consortium
Scottish Medicines Consortium abatacept, 250mg powder for concentrate for solution (Orencia ) No. (400/07) Bristol Myers Squibb Pharmaceuticals Ltd 10 August 2007 The Scottish Medicines Consortium has
More informationClinical and radiological effects of anakinra in patients with rheumatoid arthritis
Rheumatology 2003;42(Suppl. 2):ii22 ii28 doi:10.1093/rheumatology/keg329, available online at www.rheumatology.oupjournals.org Clinical and radiological effects of anakinra in patients with rheumatoid
More informationAbatacept (Orencia) for active rheumatoid arthritis. August 2009
Abatacept (Orencia) for active rheumatoid arthritis August 2009 This technology summary is based on information available at the time of research and a limited literature search. It is not intended to
More informationHorizon Scanning Technology Summary. Abatacept (Orencia) for juvenile idiopathic arthritis. National Horizon Scanning Centre.
Horizon Scanning Technology Summary National Horizon Scanning Centre Abatacept (Orencia) for juvenile idiopathic arthritis June 2007 This technology summary is based on information available at the time
More informationTo help you with terms and abbreviations used in this document that may be unfamiliar to you, a glossary is provided on the last pages.
ARTHRITIS CONSUMER EXPERTS 910B RICHARDS STREET VANCOUVER BC V6B 3C1 CANADA T: 604.974-1366 F: 604.974-1377 WWW.ARTHRITISCONSUMEREXPERTS.ORG Arthritis Consumer Experts In Health Care and Research Decision-making
More informationHorizon Scanning Technology Summary. Adalimumab (Humira) for juvenile idiopathic arthritis. National Horizon Scanning Centre.
Horizon Scanning Technology Summary National Horizon Scanning Centre Adalimumab (Humira) for juvenile idiopathic arthritis June 2007 This technology summary is based on information available at the time
More informationKevzara (sarilumab) NEW PRODUCT SLIDESHOW
Kevzara (sarilumab) NEW PRODUCT SLIDESHOW Introduction Brand name: Kevzara Generic name: Sarilumab Pharmacological class: Interleukin-6 antagonist Strength and Formulation: 150mg/1.14mL, 200mg/1.14mL;
More informationNew Medicine Report. Pimecrolimus. RED- Hospital only Date of Last Revision 6 th March 2003
New Medicine Report Document Status Pimecrolimus Reviewed by Suffolk D&T RED- Hospital only Date of Last Revision 6 th March 2003 Approved Name Pimecrolimus Trade Name Elidel Manufacturer Novartis Legal
More informationNew Medicine Report (Adopted by the CCG until review and further
New Medicine Report (Adopted by the CCG until review and further GRASS ALLERGEN TREATMENT notice) Document Status Decision following Suffolk D&TC meeting Traffic Light Decision Red for 2007 with review
More informationAtomoxetine (First known as Tomoxetine) (Adopted by the CCG until review and further notice)
New Medicine Report Document Status Atomoxetine (First known as Tomoxetine) (Adopted by the CCG until review and further notice) Post Suffolk D&TC Traffic Light Decision RED Date of Last Revision 12.07.04
More informationClinical Policy: Tocilizumab (Actemra) Reference Number: ERX.SPMN.44
Clinical Policy: (Actemra) Reference Number: ERX.SPMN.44 Effective Date: 10/16 Last Review Date: 09/16 Coding Implications Revision Log See Important Reminder at the end of this policy for important regulatory
More informationHorizon Scanning Centre November Secukinumab for active and progressive psoriatic arthritis. SUMMARY NIHR HSC ID: 5330
Horizon Scanning Centre November 2012 Secukinumab for active and progressive psoriatic arthritis. SUMMARY NIHR HSC ID: 5330 Secukinumab is a high-affinity fully human monoclonal antibody that antagonises
More informationUstekinumab (Stelara) for psoriatic arthritis second line after disease modifying anti rheumatic drugs (DMARDs)
Ustekinumab (Stelara) for psoriatic arthritis second line after disease modifying anti rheumatic drugs (DMARDs) January 2010 This technology summary is based on information available at the time of research
More informationClinical Policy: Anakinra (Kineret) Reference Number: ERX.SPA.135 Effective Date:
Clinical Policy: (Kineret) Reference Number: ERX.SPA.135 Effective Date: 10.01.16 Last Review Date: 05.18 Revision Log See Important Reminder at the end of this policy for important regulatory and legal
More informationCorporate Medical Policy
Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: abatacept_orencia 4/2008 2/2018 2/2019 2/2018 Description of Procedure or Service Abatacept (Orencia ), a
More informationWARNING: RISK OF SERIOUS INFECTIONS
RA PROGRESSION INTERRUPTED 1 DOSAGE AND ADMINISTRATION GUIDE No structural damage progression was observed at week 52 in 55.6% and in 47.8% of patients receiving KEVZARA 200 mg + MTX or 150 mg + MTX, compared
More informationClinical Policy: Tofacitinib (Xeljanz, Xeljanz XR) Reference Number: ERX.SPA.110 Effective Date:
Clinical Policy: Tofacitinib (Xeljanz, Xeljanz XR) Reference Number: ERX.SPA.110 Effective Date: 10.01.16 Last Review Date: 05.18 Revision Log See Important Reminder at the end of this policy for important
More informationCertolizumab pegol (Cimzia) for psoriatic arthritis second line
Certolizumab pegol (Cimzia) for psoriatic arthritis second line This technology summary is based on information available at the time of research and a limited literature search. It is not intended to
More informationPsoriatic Arthritis- Second Line Treatments
Psoriatic Arthritis- Second Line Treatments Second line treatments for Psoriatic Arthritis (PsA) are usually prescribed by a Rheumatologist, Dermatologist, or in a combined clinic where both the Dermatologist
More informationScottish Medicines Consortium
Scottish Medicines Consortium etanercept 25mg vial of powder for subcutaneous injection (Enbrel ) (No. 212/05) Wyeth New indication: severe active ankylosing spondylitis inadequately controlled by conventional
More informationapremilast 10mg, 20mg, 30mg tablets (Otezla ) SMC No. (1053/15) Celgene Ltd.
apremilast 10mg, 20mg, 30mg tablets (Otezla ) SMC No. (1053/15) Celgene Ltd. 08 May 2015 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards
More informationRheumatoid Arthritis. Module III
Rheumatoid Arthritis Module III Management: Biological disease modifying anti-rheumatic drugs, glucocorticoids and special situations (pregnancy & lactation) Dr Ved Chaturvedi MD, DM Senior Consultant
More informationUsing ENBREL to Treat Rheumatoid and Psoriatic Arthritis
Using ENBREL to Treat Rheumatoid and Psoriatic Arthritis Writing White Papers class Bellevue Community College TABLE OF CONTENTS TABLE OF CONTENTS...2 OVERVIEW...3 RHEUMATOID ARTHRITIS... 3 JUVENILE RHEUMATOID
More informationSuffolk PCT Drug & Therapeutics Committee New Medicine Report (Adopted by the CCG until review and further notice)
Suffolk PCT Drug & Therapeutics Committee New Medicine Report (Adopted by the CCG until review and further notice) This drug has been reviewed because it is a product that may be prescribed in primary
More informationNew Evidence reports on presentations given at EULAR Safety and Efficacy of Tocilizumab as Monotherapy and in Combination with Methotrexate
New Evidence reports on presentations given at EULAR 2009 Safety and Efficacy of Tocilizumab as Monotherapy and in Combination with Methotrexate Report on EULAR 2009 presentations Tocilizumab inhibits
More information1 Executive summary. Background
1 Executive summary Background Rheumatoid Arthritis (RA) is the most common inflammatory polyarthropathy in the UK affecting between.5% and 1% of the population. The mainstay of RA treatment interventions
More informationOrencia (abatacept) for Rheumatoid Arthritis. Media backgrounder
Orencia (abatacept) for Rheumatoid Arthritis Media backgrounder What is Orencia (abatacept)? Orencia (abatacept) is the first biologic agent to be available in both an intravenous (IV) and a self-injectable,
More informationCanadian Society of Internal Medicine Annual Meeting 2016 Montreal, QC
Canadian Society of Internal Medicine Annual Meeting 2016 Montreal, QC Update on the Treatment of Rheumatoid Arthritis Sabrina Fallavollita MDCM McGill University Canadian Society of Internal Medicine
More informationPRODUCT INFORMATION. ORENCIA (abatacept) (LYOPHILIZED POWDER FOR IV INFUSION) (SOLUTION FOR SUBCUTANEOUS ADMINISTRATION)
PRODUCT INFORMATION ORENCIA (abatacept) (LYOPHILIZED POWDER FOR IV INFUSION) (SOLUTION FOR SUBCUTANEOUS ADMINISTRATION) NAME OF THE MEDICINE ORENCIA (abatacept (rch)) ORENCIA (abatacept (rch)). Abatacept
More informationClinical Policy: Ustekinumab (Stelara) Reference Number: ERX.SPA.01 Effective Date:
Clinical Policy: (Stelara) Reference Number: ERX.SPA.01 Effective Date: 04.01.17 Last Review Date: 11.17 Revision Log See Important Reminder at the end of this policy for important regulatory and legal
More informationCorporate Medical Policy
Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: golimumab_simponi 8/2013 2/2018 2/2019 3/2018 Description of Procedure or Service Golimumab (Simponi and
More informationClinical Policy: Abatacept (Orencia) Reference Number: ERX.SPA.123 Effective Date:
Clinical Policy: (Orencia) Reference Number: ERX.SPA.123 Effective Date: 10.01.16 Last Review Date: 05.18 Revision Log See Important Reminder at the end of this policy for important regulatory and legal
More informationClinical Policy: Anakinra (Kineret) Reference Number: CP.PHAR.244 Effective Date: Last Review Date: Line of Business: HIM, Medicaid
Clinical Policy: (Kineret) Reference Number: CP.PHAR.244 Effective Date: 08.16 Last Review Date: 11.18 Line of Business: HIM, Medicaid Coding Implications Revision Log See Important Reminder at the end
More informationScottish Medicines Consortium
Scottish Medicines Consortium ustekinumab, 45mg solution for injection (Stelara ) No. (572/09) Janssen-Cilag Ltd 15 January 2010 The Scottish Medicines Consortium (SMC) has completed its assessment of
More informationClinical Policy: Baricitinib (Olumiant) Reference Number: CP.PHAR.135 Effective Date: Last Review Date: 11.18
Clinical Policy: (Olumiant) Reference Number: CP.PHAR.135 Effective Date: 07.24.18 Last Review Date: 11.18 Line of Business: Medicaid Revision Log See Important Reminder at the end of this policy for important
More informationRHEUMATOID ARTHRITIS DRUGS
Rheumatology Biologics Criteria from the Exceptional Access Program RHEUMATOID ARTHRITIS DRUGS DRUG NAME BRS REIMBURSED DOSAGE FORM/ STRENGTH Adalimumab Humira 40 mg/0.8 syringe and 40mg/0.8 pen for Anakinra
More informationTRANSPARENCY COMMITTEE OPINION. 26 April 2006
TRANSPARENCY COMMITTEE OPINION 26 April 2006 REMICADE 100 mg powder for concentrate for solution for infusion Box of 1 (CIP code: 562 070.1) Applicant : laboratoires Schering Plough List I Drug for hospital
More informationClinical Policy: Sarilumab (Kevzara) Reference Number: CP.PHAR.346 Effective Date: Last Review Date: 11.18
Clinical Policy: (Kevzara) Reference Number: CP.PHAR.346 Effective Date: 07.18.17 Last Review Date: 11.18 Line of Business: Medicaid Revision Log See Important Reminder at the end of this policy for important
More informationadalimumab, 40mg/0.8mL, solution for injection (Humira ) SMC No. (858/13) AbbVie Ltd (previously part of Abbott)
adalimumab, 40mg/0.8mL, solution for injection (Humira ) SMC No. (858/13) AbbVie Ltd (previously part of Abbott) 08 March 2013 The Scottish Medicines Consortium (SMC) has completed its assessment of the
More informationClinical Policy: Etanercept (Enbrel) Reference Number: PA.CP.PHAR.250 Effective Date: 01/18 Last Review Date: 08/17 Line of Business: Medicaid
Clinical Policy: (Enbrel) Reference Number: PA.CP.PHAR.250 Effective Date: 01/18 Last Review Date: 08/17 Line of Business: Medicaid Coding Implications Revision Log Description (Enbrel ) is tumor necrosis
More informationNew Evidence reports on presentations given at EULAR Tocilizumab for the Treatment of Rheumatoid Arthritis and Juvenile Idiopathic Arthritis
New Evidence reports on presentations given at EULAR 2011 Tocilizumab for the Treatment of Rheumatoid Arthritis and Juvenile Idiopathic Arthritis Report on EULAR 2011 presentations Benefit of continuing
More informationTechnology appraisal guidance Published: 4 June 2015 nice.org.uk/guidance/ta340
Ustekinumab for treating active psoriatic arthritis Technology appraisal guidance Published: 4 June 2015 nice.org.uk/guidance/ta340 NICE 2017. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-ofrights).
More informationPsoriatic Arthritis- Secondary Care
Psoriatic Arthritis- Secondary Care Our Psoriatic Arthritis: First Line Treatments information sheet gives information on the treatments that can be prescribed by a GP, or that might be prescribed if the
More informationClinical Policy: Certolizumab (Cimzia) Reference Number: PA.CP.PHAR.247 Effective Date: 01/18 Last Review Date: 08/17 Line of Business: Medicaid
Clinical Policy: (Cimzia) Reference Number: PA.CP.PHAR.247 Effective Date: 01/18 Last Review Date: 08/17 Line of Business: Medicaid Coding Implications Revision Log Description (Cimzia ) is a tumor necrosis
More informationPublic observer slides
Public observer slides Lead team presentation Certolizumab pegol and secukinumab for treating active psoriatic arthritis following inadequate response to disease modifying antirheumatic drugs Multiple
More informationinfliximab, 100mg, powder for concentrate for solution for infusion (Inflectra ) SMC No. (1007/14) Hospira UK Ltd.
infliximab, 100mg, powder for concentrate for solution for infusion (Inflectra ) SMC No. (1007/14) Hospira UK Ltd. 07 November 2014 (Issued 06 March 2015) The Scottish Medicines Consortium (SMC) has completed
More informationConcordance with the British Society of Rheumatology (BSR) 2010 recommendations on eligibility criteria for the first biologic agent
Concordance with the British Society of Rheumatology (BSR) 2010 recommendations on eligibility criteria for the first biologic agent Michela Frendo, John Paul Caruana Galizia, Andrew A Borg Abstract Aims:
More informationEfficacy of Anakinra in Bone: Comparison to Other Biologics
Advances In Therapy Volume 19 No. 1 January/February 2002 Efficacy of Anakinra in Bone: Comparison to Other Biologics Stephen A. Paget, M.D. Hospital for Special Surgery Department of Rheumatic Disease
More informationSYNOPSIS. Clinical Study Report IM Double-blind Period
Name of Sponsor/Company: Bristol-Myers Squibb Name of Finished Product: Abatacept () Name of Active Ingredient: Abatacept () Individual Study Table Referring to the Dossier SYNOPSIS (For National Authority
More informationCoverage Criteria: Express Scripts, Inc. monograph dated 12/15/ months or as otherwise noted by indication
BENEFIT DESCRIPTION AND LIMITATIONS OF COVERAGE ITEM: PRODUCT LINES: COVERED UNDER: DESCRIPTION: CPT/HCPCS Code: Company Supplying: Setting: Kineret (anakinra subcutaneous injection) Commercial HMO/PPO/CDHP
More informationTechnology appraisal guidance Published: 25 August 2010 nice.org.uk/guidance/ta195
Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a TNF inhibitor Technology appraisal guidance Published: 25 August 2010 nice.org.uk/guidance/ta195
More informationClinical Policy: Etanercept (Enbrel) Reference Number: CP.PHAR.250 Effective Date: 08/16 Last Review Date: 08/17 Line of Business: Medicaid
Clinical Policy: (Enbrel) Reference Number: CP.PHAR.250 Effective Date: 08/16 Last Review Date: 08/17 Line of Business: Medicaid Coding Implications Revision Log See Important Reminder at the end of this
More informationNew Evidence reports on presentations given at EULAR Tocilizumab for the Treatment of Rheumatoid Arthritis
New Evidence reports on presentations given at EULAR 2012 Tocilizumab for the Treatment of Rheumatoid Arthritis Report on EULAR 2012 presentations Tocilizumab monotherapy is superior to adalimumab monotherapy
More informationImmunological Aspect of Ozone in Rheumatic Diseases
Immunological Aspect of Ozone in Rheumatic Diseases Prof. Dr. med. Z. Fahmy Chief Consulting Rheumatologist Augusta Clinic for Rheumatic Diseases And Rehabilitation Bad Kreuznach Germany Rheumatoid arthritis
More informationCDEC FINAL RECOMMENDATION
CDEC FINAL RECOMMENDATION TOFACITINIB (Xeljanz Pfizer Canada Inc.) Indication: Rheumatoid Arthritis Recommendation: The Canadian Drug Expert Committee (CDEC) recommends that tofacitinib be listed, in combination
More informationClinicalTrials.gov Protocol Registration and Results System (PRS) Receipt Release Date: 01/19/2016. ClinicalTrials.gov ID: NCT
ClinicalTrials.gov Protocol Registration and Results System (PRS) Receipt Release Date: 01/19/2016 ClinicalTrials.gov ID: NCT00595413 Study Identification Unique Protocol ID: 27905 Brief Title: Atacicept
More informationLOCALLY AVAILABLE BIOLOGIC AGENTS IN THE TREATMENT OF PSORIATIC ARTHRITIS
Locally Available Biologic Agents in the Treatment of Psoriatic Arthritis 253 Phil. J. Internal Medicine, 47: 253-259, Nov.-Dec., 2009 LOCALLY AVAILABLE BIOLOGIC AGENTS IN THE TREATMENT OF PSORIATIC ARTHRITIS
More informationBRIEFING DOCUMENT. human, recombinant fusion protein: extracellular domain of CTLA-4 and Fc domain of human IgG1
BRIEFING DOCUMENT Application Type BLA Submission Number 125118/0 Reviewer Name Team Leader Division Director Established Name (Proposed) Trade Name Applicant Formulation Dosing Regimen Indication Intended
More informationSHARED CARE PRESCRIBING GUIDELINE LEFLUNOMIDE IN ADULT PATIENTS WITH RHEUMATOID ARTHRITIS DOCUMENT DETAILS
SHARED CARE PRESCRIBING GUIDELINE LEFLUNOMIDE IN ADULT PATIENTS WITH RHEUMATOID ARTHRITIS DOCUMENT DETAILS Document type Shared Care Prescribing Guideline Document name Shared Care Prescribing Guideline:
More informationMMS Pharmacology Lecture 2. Antirheumatic drugs. Dr Sura Al Zoubi
MMS Pharmacology Lecture 2 Antirheumatic drugs Dr Sura Al Zoubi Revision Rheumatoid Arthritis Definition (RA): is the most common systemic inflammatory disease characterized by symmetrical inflammation
More informationPRODUCT INFORMATION HUMIRA
NAME OF THE MEDICINE Adalimumab (rch) DESCRIPTION PRODUCT INFORMATION HUMIRA (adalimumab) is a recombinant human immunoglobulin (IgG1) monoclonal antibody containing only human peptide sequences. was created
More informationNew Evidence reports on presentations given at ACR Improving Radiographic, Clinical, and Patient-Reported Outcomes with Rituximab
New Evidence reports on presentations given at ACR 2009 Improving Radiographic, Clinical, and Patient-Reported Outcomes with Rituximab From ACR 2009: Rituximab Rituximab in combination with methotrexate
More information2017 Blue Cross and Blue Shield of Louisiana
Applies to all products administered or underwritten by Blue Cross and Blue Shield of Louisiana and its subsidiary, HMO Louisiana, Inc.(collectively referred to as the Company ), unless otherwise provided
More informationcertolizumab pegol (Cimzia )
Applies to all products administered or underwritten by Blue Cross and Blue Shield of Louisiana and its subsidiary, HMO Louisiana, Inc.(collectively referred to as the Company ), unless otherwise provided
More informationAssessment group response to Wyeth commentary on assessment report
Assessment group response to Wyeth commentary on assessment report Subject & Wyeth s comments related section/page Model patient The TAR economic model is a complex model that attempts to reflect the population
More informationRheumatoid arthritis
Rheumatoid arthritis 1 Definition Rheumatoid arthritis is one of the most common inflammatory disorders affecting the population worldwide. It is a systemic inflammatory disease which affects not only
More information1.0 Abstract. Title. Keywords. Rationale and Background
1.0 Abstract Title A Prospective, Multi-Center Study in Rheumatoid Arthritis Patients on Adalimumab to Evaluate its Effect on Synovitis Using Ultrasonography in an Egyptian Population Keywords Synovitis
More informationCenter for Evidence-based Policy
P&T Committee Brief Targeted Immune Modulators: Comparative Drug Class Review Alison Little, MD Center for Evidence-based Policy Oregon Health & Science University 3455 SW US Veterans Hospital Road, SN-4N
More informationORENCIA (abatacept) Demonstrates Comparable Efficacy to Humira ( adalimumab
ORENCIA (abatacept) Demonstrates Comparable Efficacy to Humira (adalimumab) in Patients with Moderate to Severe Rheumatoid Arthritis in First Head-to-Head Study of These Agents ORENCIA demonstrated comparable
More informationRegulatory Status FDA- approved indication: Simponi and Simponi ARIA are tumor necrosis factor (TNF) blockers indicated for the treatment of: (2-3)
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.70.51 Subject: Simponi / Simponi ARIA Page: 1 of 9 Last Review Date: March 16, 2018 Simponi / Simponi
More informationThe Hospital for Sick Children Technology Assessment at SickKids (TASK)
The Hospital for Sick Children Technology Assessment at SickKids (TASK) THE USE OF BIOLOGIC RESPONSE MODIFIERS IN POLYARTICULAR-COURSE JUVENILE IDIOPATHIC ARTHRITIS Report No. 2010-01 Date: January 11,
More informationWARNING: RISK OF SERIOUS INFECTIONS
DOSAGE AND ADMINISTRATION GUIDE RA PROGRESSION INTERRUPTED 1 No structural damage progression was observed at week 52 in 55.6% and in 47.8% of patients receiving KEVZARA 200 mg + MTX or 150 mg + MTX, compared
More informationTechnology appraisal guidance Published: 25 August 2010 nice.org.uk/guidance/ta199
Etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis Technology appraisal guidance Published: 25 August 2010 nice.org.uk/guidance/ta199 NICE 2018. All rights reserved. Subject
More information1. Background: Infliximab is administered parenterally; therefore, it is not covered under retail pharmacy benefits.
Subject: Infliximab (Remicade ) Original Original Committee Approval: October 13, 2006 Revised Last Committee Approval: December 3, 2008 Last Review: October 19, 2007 1. Background: Infliximab is a genetically
More informationSummary of Risk Minimization Measures
Table 6.1.4-1: Summary of Risk Minimization Measures Safety Concern Vaccination Hepatic and renal impairment Combination therapy Elderly Routine Risk Minimization Measures Specific subsection on vaccination
More informationDERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC)
DERBYSHIRE JOINT AREA PRERIBING COMMITTEE (JAPC) Derbyshire commissioning guidance on biologic drugs f the treatment of Rheumatoid arthritis with methotrexate This algithm is a tool to aid the implementation
More informationAbatacept: first T cell co-stimulation modulator for severe active RA
Abatacept: first T cell co-stimulation modulator for severe active RA Steve Chaplin MSc, MRPharmS and Andrew Ostor FRACP PRODUCT PROFILE Proprietary name: Orencia Constituents: abatacept Dosage and method
More informationEfficacy and Safety of Tocilizumab in the Treatment of Rheumatoid Arthritis and Juvenile Idiopathic Arthritis
New Evidence reports on presentations given at EULAR 2010 Efficacy and Safety of Tocilizumab in the Treatment of Rheumatoid Arthritis and Juvenile Idiopathic Arthritis Report on EULAR 2010 presentations
More informationGolimumab: In Combination with Methotrexate as Once Monthly Treatment for Moderate to Severe Rheumatoid Arthritis
Clinical Medicine Reviews in Therapeutics Review Golimumab: In Combination with Methotrexate as Once Monthly Treatment for Moderate to Severe Rheumatoid Arthritis Lauren Keyser McCluggage 1 and Kelly Michelle
More informationClinical Policy: Certolizumab (Cimzia) Reference Number: CP.PHAR.247 Effective Date: 08/16 Last Review Date: 08/17 Line of Business: Medicaid
Clinical Policy: (Cimzia) Reference Number: CP.PHAR.247 Effective Date: 08/16 Last Review Date: 08/17 Line of Business: Medicaid Coding Implications Revision Log See Important Reminder at the end of this
More informationNHS Suffolk Shared Care Guidelines for the Treatment of Rheumatoid Arthritis with LEFLUNOMIDE
Suffolk Drug & Therapeutics Committee NHS Suffolk Shared Care Guidelines for the Treatment of Rheumatoid Arthritis with LEFLUNOMIDE What is a shared care document? Suffolk D&T operates a traffic light
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,700 108,500 1.7 M Open access books available International authors and editors Downloads Our
More informationMedical Management of Rheumatoid Arthritis (RA)
Medical Management of Rheumatoid Arthritis (RA) Dr Lee-Suan Teh Rheumatologist Royal Blackburn Hospital Educational objectives ABC Appreciate the epidemiology of RA Be able to diagnosis of RA Competent
More informationPharmacy Management Drug Policy
SUBJECT: Cimzia (Certolizumab pegol) - for Ankylosing Spondylitis, Crohn s Disease, Psoriatic Arthritis and Rheumatoid Arthritis POLICY NUMBER: PHARMACY-07 EFFECTIVE DATE: 5/2009 LAST REVIEW DATE: 6/13/2018
More informationTechnology appraisal guidance Published: 11 October 2017 nice.org.uk/guidance/ta480
Tofacitinib for moderate to severeere rheumatoid arthritis Technology appraisal guidance Published: 11 October 2017 nice.org.uk/guidance/ta480 NICE 2018. All rights reserved. Subject to Notice of rights
More informationMedication Policy Manual. Topic: Xeljanz, tofacitinib Date of Origin: January 21, 2013
Medication Policy Manual Policy No: dru289 Topic: Xeljanz, tofacitinib Date of Origin: January 21, 2013 Committee Approval Date: January 19, 2015 Next Review Date: January 2016 Effective Date: April 1,
More informationStelara. Stelara (ustekinumab) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.90.04 Subject: Stelara Page: 1 of 9 Last Review Date: September 20, 2018 Stelara Description Stelara
More informationNational Institute for Health and Clinical Excellence Level 1A, City Tower Piccadilly Plaza Manchester M1 4BD
xxxxx xxxxxx xxxxxx xxxxxxx - xxxxxxxxx x National Institute for Health and Clinical Excellence Level 1A, City Tower Piccadilly Plaza Manchester M1 4BD Dear xxxxx, 1st September 2011 Comments on the August
More informationSee Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: (Actemra) Reference Number: HIM.PA.SP32 Effective Date: 05/17 Last Review Date: Line of Business: Health Insurance Marketplace Coding Implications Revision Log See Important Reminder at
More informationClinical Policy: Certolizumab (Cimzia) Reference Number: ERX.SPA.167 Effective Date:
Clinical Policy: (Cimzia) Reference Number: ERX.SPA.167 Effective Date: 10.01.16 Last Review Date: 11.17 Revision Log See Important Reminder at the end of this policy for important regulatory and legal
More informationClinical Policy: Certolizumab (Cimzia) Reference Number: ERX.SPA.167 Effective Date:
Clinical Policy: (Cimzia) Reference Number: ERX.SPA.167 Effective Date: 1.1.16 Last Review Date: 11.17 Revision Log See Important Reminder at the end of this policy for important regulatory and legal information.
More informationCost-effectiveness analysis of biological treatments for rheumatoid arthritis Chiou C F, Choi J, Reyes C M
Cost-effectiveness analysis of biological treatments for rheumatoid arthritis Chiou C F, Choi J, Reyes C M Record Status This is a critical abstract of an economic evaluation that meets the criteria for
More informationMabThera (rituximab) NICE STA Submission
MabThera (rituximab) NICE STA Submission ACHIEVING CLINICAL EXCELLENCE IN THE TREATMENT OF RHEUMATOID ARTHRITIS Roche Submission to the National Institute for Health and Clinical Excellence 21 st November
More informationCriteria Inclusion criteria Exclusion criteria. despite treatment with csdmards, NSAIDs, and/or previous anti-tnf therapy and/or
Supplementary Material Table S1 Eligibility criteria (PICOS) for the SLR Criteria Inclusion criteria Exclusion criteria Population Adults (aged 18 years) with active PsA despite treatment with csdmards,
More information