NICE has recommended Remicade (infliximab) and Humira (adalimumab) as treatment options for some people with severe Crohn’s disease whose condition has not responded to conventional therapy.
The draft guidance recommends the drugs for adults with non-fistulising, severe Crohn’s disease that has not responded to conventional treatment.
The Institute also ruled that treatment should normally be started with the less expensive drug, taking into account drug administration costs, required dose and price per dose.
Infliximab was also recommended for adults with severe, fistulising Crohn’s disease, and for children and young people aged 6-17 years old with severe Crohn’s disease.
Dr Carole Longson, Health Technology Evaluation Centre Director, said: “These treatments are not suitable for all people with Crohn’s disease. However, it is clear that infliximab and adalimumab may provide benefit to some severely ill patients; hence our draft guidance is targeted at people who have the most severe forms of Crohn’s disease. It is also clear that these drugs should only be prescribed by specialists experienced in treating people with Crohn’s disease.”
Crohn’s disease is a chronic inflammatory condition of unknown cause affecting the gastrointestinal tract (gut). It is estimated that around 60,000 people in the UK have the disease, of whom approximately 3,000 (5%) have the most severe forms of the condition.
Sometimes Crohn’s disease causes the formation of abnormal passageways (‘fistulas’) between parts of the intestine or between the intestine and the skin. It can also affect other parts of the body, such as the eyes or the joints. People with Crohn’s disease have recurrent attacks, i.e. periods of flares and ‘remission’.
The draft guidance is available for public consultation on the NICE website until 10 December 2009 and final guidance is expected in spring 2010. Until this time, NHS bodies have been encouraged to make local funding decisions on the treatments.