NICE recommends four treatments for arthritis in children
pharmafile | October 22, 2015 | News story | Medical Communications, Research and Development | NICE, arthritis, jia
UK Healthcare guidance body NICE has today published final draft guidance recommending four drugs for the treatment of juvenile ideopathic arthritis (JIA) in children and young people.
NICE has provisionally recommended Orencia (abatacept, Bristol-Myers Squibb), Humira (adalimumab), AbbVie), Enbrel (etanercept, Pfizer) and RoActemra (tocilizumab, Roche), within their marketing authorisations, for the condition.
All four drugs are disease-modifying anti-rheumatic drugs (DMARDs), which aim to reduce or halt joint damage by reducing or stopping disease activity. They are all licensed for use where previous treatment has been associated with an inadequate response or with intolerance.
The draft guidance states that when more than 1 drug is suitable, treatment should be started with the least expensive drug, taking into account administration costs, the dose needed and the product cost per dose.
JIA affects about 10,000 children and young people in the UK, and is a collective term for a group of inflammatory joint conditions which last for more than six weeks in people under 16 years of age.
It can affect children and young people of any age and causes pain, swelling and limitation of movement, with symptoms varying daily. The condition- the cause of which is unknown- may start with symptoms such as a fever or rash, with joints eventually becoming swollen and inflamed.
In more severe cases, JIA can cause growth impairment, joint contractures, joint disease requiring joint replacements (in 7%-28% of children), eye issues and other problems unrelated to the joints, including inflammatory bowel disease and psoriasis, as well as permanent disability.
JIA can significantly lessen sufferer’s ability to perform day-to-day activities, as well as impair their personal and social functioning and development. Children and young people with JIA often miss out on schooling and other childhood activities, and as adults they may be limited in their ability to work.
Treatments are focused on controlling joint pain and inflammation, reducing joint damage, disability and loss of function and maintaining or improving quality of life. However, despite treatment, about a third of children with JIA will not achieve remission from the condition and will need further rheumatological care as adults.
Professor Carole Longson, NICE Health Technology Evaluation Centre director, says: “Juvenile idiopathic arthritis is a progressive degenerative condition that not only affects the quality of life of the child or young person with the disease, but can also affect the quality of life of their carers and family.
“The Committee heard there is a link between the length of time the disease remains uncontrolled and the amount of joint damage and growth impairment. They also heard that being able to access effective treatments at an early stage of the disease can help improve long-term outcomes. We are therefore pleased to be able to recommend these drugs as options for children and young people with juvenile idiopathic arthritis in today’s draft guidance.”
The draft guidance is now with consultees, who may appeal against it before NICE issues its final guidance.
Joel Levy
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