The National Institute for Health and Care Excellence (NICE) has approved golimumab (Simponi) as a treatment option for severe axial spondyloarthritis.
Golimumab is recommended for treatment of adults with severe non-radiographic axial spondyloarthritis who have not responded adequately to, or are intolerant to, NSAIDs.
The recommended dose is 50 mg given subcutaneously once a month, on the same date every month for 12-14 weeks (ie, 3-4 doses). Inadequate response at this point calls for reconsideration of therapy. Dosage may be increased to 100 mg in heavier patients (>100 kg) not responding adequately to 50 mg after 3-4 doses. Inadequate response after 3-4 additional doses of 100 mg calls for reconsideration of therapy.
Therapeutic response should be assessed at 12 weeks of therapy through appropriate reductions in either Bath Ankylosing Spondylitis Disease Activity Index score or spinal pain visual analogue scale score.
NICE's recommendation comes after evidence of similar overall health benefits and costs of golimumab compared with previously approved therapies including adalimumab, etanercept and certolizumab pegol. If patients and their clinicians have to make a treatment choice, the least expensive option should be chosen after considering administration costs and patient access schemes.