The National Institute for Health and Care Excellence (NICE) has published final draft guidance recommending Janus kinase (JAK) inhibitor tofacitinib (Xeljanz, Pfizer) as an option for treating active polyarticular juvenile arthritis and juvenile psoriatic arthritis in people aged two years and older.
Tofacitinib is available for young people whose arthritis has had an inadequate response to disease-modifying antirheumatic drugs (DMARDs) and only if:
- A tumour necrosis factor (TNF)-alpha inhibitor is not suitable or does not control the condition well enough, and
- The company provides tofacitinib according to the commercial arrangement.
NICE said that clinical evidence shows that tofacitinib is effective when compared with a placebo and indirect comparisons suggest it has a similar effect to other treatments for the same indication.
In England, about 3000 people in total have juvenile idiopathic arthritis, and more than 1000 would be eligible for treatment with tofacitinib.
Tofacitinib is the second drug that has been recommended as part of a new approach to the cost comparison fast track appraisal process being piloted by NICE. The pilot programme works by using a subset of the appraisal committee to assess low-risk treatments, comparing them to similar therapies that have already been appraised by NICE. This sub-committee is then able to make a recommendation without requiring a full committee meeting.
Meindert Boysen, deputy chief executive and director of the Centre for Health Technology Evaluation at NICE said: “I am very pleased NICE has been able to recommend tofacitinib for young people with this form of arthritis. Tofacitinib has the potential to help young people with this condition be more able to take part in some physical activities and sports, which will significantly help improve their quality of life.”
“I am also pleased the company worked with NICE and our independent appraisal committee to supply evidence which meant we could not only make a positive recommendation, but one which fast-tracks access for this group of people in the NHS.”
This article originally appeared on Univadis, part of the Medscape Professional Network.
