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NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
Why the committee made these recommendationsExpected publication date: 24 February 2021People with severe rheumatoid arthritis have a number of advanced treatment
options (biological and targeted synthetic DMARDs) available to them if their disease
has not responded well enough to 2 or more conventional DMARDs. These
advanced treatment options are currently not available for people with moderate
rheumatoid arthritis.
Clinical trials show that filgotinib with methotrexate or other conventional DMARDs is
more effective than adalimumab with methotrexate or methotrexate alone for treating
moderate to severe rheumatoid arthritis that has not responded well enough to 2 or
more conventional DMARDs. It is also more effective than conventional DMARDs
alone for treating moderate to severe active rheumatoid arthritis that has not
responded well enough to 1 or more biological DMARDs.
There are no trials comparing filgotinib with the full range of biological and targeted
synthetic DMARDs in severe disease. However, an indirect comparison shows that
filgotinib with conventional DMARDs (including methotrexate) works as well as the
biological and targeted synthetic DMARDs recommended by NICE.
The most likely cost-effectiveness estimates show that filgotinib with methotrexate is
an acceptable use of NHS resources for some people with moderate and severe
rheumatoid arthritis (see sections 1.1 to 1.3).
The cost effectiveness of filgotinib monotherapy is more uncertain but is still likely to
be within what NICE considers an acceptable use of NHS resources, therefore it is
recommended.
www.nice.org.uk/guidance/gid-ta10541/...