Tocilizumab

Red

Brand Name(s):RoActemra

Indication:Rheumatoid arthritis in adults & Systemic juvenile idiopathic arthritis in children

Rationale:1,2,3,8

Considered:Jan-09

Review Date:Aug-24

Comments:
Drug Safety Update
Tocilizumab (RoActemra): rare risk of serious liver injury including cases requiring transplantation
July19
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NICE TA 375
Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed.
Full information can be found at:http://www.nice.org.uk/guidance/ta375/resources/adalimumab-etanercept-infliximab-certolizumab-pegol-golimumab-tocilizumab-and-abatacept-for-rheumatoid-arthritis-not-previously-treated-with-dmards-or-after-conventional-dmards-only-have-failed-82602790920133
January 2016NICE TA 373
Tocilizumab for treating juvenile idiopathic arthritis
Full guidance available at:http://www.nice.org.uk/guidance/ta373/resources/abatacept-adalimumab-etanercept-and-tocilizumab-for-treating-juvenile-idiopathic-arthritis-82602787560901
Dec 2015

Tocilizumab in combination with methotrexate is recommended as an option for the treatment of rheumatoid arthritis in adults if:
the disease has responded inadequately to disease-modifying anti-rheumatic drugs (DMARDs) and it is used as described for tumour necrosis factor (TNF) inhibitor treatments in Adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis (NICE technology appraisal guidance 130), specifically the recommendations on disease activity and choice of treatment or the disease has responded inadequately to DMARDs and a TNF inhibitor and the person cannot receive rituximab because of a contraindication to rituximab, or because rituximab is withdrawn because of an adverse event, and tocilizumab is used as described for TNF inhibitor treatments in Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a TNF inhibitor (NICE technology appraisal guidance 195), specifically the recommendations on disease activity or the disease has responded inadequately to one or more TNF inhibitor treatments and to rituximab and the manufacturer provides tocilizumab with the discount agreed as part of the patient accessscheme.

People currently receiving tocilizumab for the treatment of rheumatoid arthritis who do not meet the criteria in 1.1 should have the option to continuetreatment until they and their clinicians consider it appropriate to stop.
Issued: February 2012

Tocilizumab for the treatment of systemic juvenile idiopathic arthritis
Guidance
Tocilizumab is recommended for the treatment of systemic juvenile idiopathic
arthritis in children and young people aged 2 years and older whose disease
has responded inadequately to non-steroidal anti-inflammatory drugs
(NSAIDs), systemic corticosteroids and methotrexate if the manufacturer
makes tocilizumab available with the discount agreed as part of the patient
access scheme.
Tocilizumab is not recommended for the treatment of systemic juvenile
idiopathic arthritis in children and young people aged 2 years and older whose
disease continues to respond to methotrexate or who have not been treated
with methotrexate.
Children and young people currently receiving tocilizumab for the treatment of
systemic juvenile idiopathic arthritis who do not meet the criteria in 1.1 should
have the option to continue treatment until it is considered appropriate to stop.
This decision should be made jointly by the clinicians, and the child or young
person and/or their parents or carers.

NICE technology appraisal guidance 238 December 2011