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SHTAC is assessing biologic drug therapies for the treatment of juvenile idiopathic arthritis

Published: 19 November 2014
Xray image of joints

SHTAC is assessing the clinical-effectiveness and cost-effectiveness of abatacept, adalimumab, etanercept and tocilizumab for the treatment of juvenile idiopathic arthritis for the National Institute for Health and Care Excellence (NICE) Multiple Technology Appraisal process.

Juvenile idiopathic arthritis (JIA) is an inflammation of the joints that begins in people under 16 years of age where the cause or trigger is uncertain or unknown. JIA lasts for at least six weeks and causes pain, stiffness and swelling of the affected joints.

There are several different forms of JIA, characterised by the number of affected joints or associated features. This assessment will include extended oligoarticular JIA (at the start 4 or fewer joints are affected, by after 6 months or longer 5 or more joints become affected); polyarticular JIA (5 or more joints are affected); enthesitis related arthritis (the arthritis is associated with swelling of tendons at the point of insertion into bones, these insertion points are called enthesitis); and psoriatic arthritis (associated with psoriasis which is a flaky skin condition).

Treatment typically follows a stepped approach that begins with a non-steroidal anti-inflammatory drug, followed by corticosteroids, and disease modifying anti-rheumatic drugs (DMARD) such as methotrexate. If an adequate response is not achieved with methotrexate one of several biologic DMARDs may be offered. NICE guidance currently recommends the biologic DMARD etancercept for children aged 4 to 17 years who have active JIA in at least five joints and whose condition has not responded adequately to methotrexate or who have been unable to tolerate treatment with methotrexate. This assessment will inform an update to the guidance to reflect broadening of the licensed indication for etanercept and to include newer licensed biological DMARDs abatacept, adalimumab, and tocilizumab. NICE is expected to issue the updated guidance in February 2016

For more information on SHTAC’s research please visit our Research page.

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