NICE must rethink denying Abatacept

IN a snub to thousands of people with rheumatoid arthritis, the National Institute of Health and Clinical Excellence (NICE) has published final guidance stating that the drug Abatacept (Orencia) is not cost effective for the NHS and should be refused.  The drug for severe rheumatoid arthritis (RA) was only launched in the UK in June 2007. Manufacturers Bristol-Myers Squibb said at the time that it promised long-term efficacy for people with RA who have not responded positively to anti-TNF therapy.

Abatacept is licensed in the UK for use in combination with methotrexate for adults with active moderate to severe RA, who have responded poorly to other disease modifying anti-rheumatic drugs (DMARDs), and to at least one anti-TNF.

"It's a huge blow. This decision will dash the hopes of thousands. The fact that the new-generation drug rituximab (MabThera) was approved recently doesn't mean that all people failed by anti-TNFs will be suitable for it. Abatacept was a bright, new hope for them, and to put it beyond their reach will seem catastrophic.

People qualified to receive anti-TNF treatment already have serious, active rheumatoid arthritis. It's very debilitating and destructive, and if not properly treated, those with the severest form of the condition can kiss goodbye to their hopes of halting the disease's damaging progress.

This harsh decision means there's no place left to go if you've been failed by rituximab, or the anti-TNF treatments. Whilst NICE is obliged to make its decisions on NHS cost-effectiveness, the narrow focus merely robs Peter to pay Paul. Instead of funding Abatacept, now the taxpayer will foot the bill for expensive orthopaedic and palliative care for people who might do well on the drug, if allowed it. Many may end up on disability or incapacity benefits as well." said Arthritis Care's spokesman Jane Spence.

The final NICE guidance, published, states that Abatacept is not recommended on the NHS for treatment of people with rheumatoid arthritis. However, it says the small number of people currently receiving it should be allowed to continue until they and their clinicians consider it appropriate to stop.

"Arthritis Care speaks up for people with arthritis and we'll make a robust appeal against this ruling. We'll urge NICE to revisit the evidence and reverse its decision, which, if allowed to stand, will deny many who potentially qualify for this treatment, the benefits it offers" said Spence.

The launch of Abatacept in the UK followed the grant of its European Commission licence on May 21, 2007. NICE guidance applies to England and Wales. Decisions in Northern Ireland usually mirror NICE’s lead. In September, the equivalent body in Scotland, the Scottish Medicines Consortium (SMC), also refused to recommend Abatacept.

4,000 PEOPLE ACCESS MENINGITIS INFO ONLINE EVERY DAY

THE Meningitis Trust has launched a new website as part of a series of events and activities to commemorate its 21st anniversary.  The charity has marked the milestone with a complete redesign of its online information, as well as its awareness literature and signs and symptoms cards, in readiness for the next 21 years. 

The website has been developed using the latest 'web2' technology enabling visitors to navigate the site with just one click. Proof that the new set-up is simple to use came just 30 minutes after going live, when a visitor registered online for a fundraising event.   Even before the website's official launch, more than 4,000 people a day were accessing the new, easy to navigate site.

New technology behind the site also enables staff at the Meningitis Trust direct access to its content, allowing it to be changed and updated on a daily basis. That means the charity can instantly communicate the latest information on the disease, and supporters will be able to quickly obtain current news on fundraising and community activities.

Sue Davie, Chief Executive of the Meningitis Trust, says:- "It is very important that the website is clear and easy to navigate so whether users are in need of signs and symptoms information or support services following the disease, or want to know how they can get involved in fundraising, the information is simple to access and understand."

The new website should be accessed to obtain copies of free signs and symptoms cards or information about meningitis and the work of the Meningitis Trust call 01453 768000

Signal Changes to Improve Safety

CHANGES are to be made to a city centre road junction to improve safety for pedestrians.

An all-red phase for traffic is to be introduced at the junction of Upper Parliament Street / Catharine Street / Princes Road to allow pedestrians to cross safely. During this phase all traffic at the junction will be stopped.

This move follows concern that some motorists were turning left into Catharine Street – on the green phase for pedestrians - from Upper Parliament Street even though this manoeuvre is prohibited. 

To prevent the danger from this illegal turn the new all-red phase will be introduced in the week starting 5 November 2007.

Cllr Mike Storey, Executive Member for Regeneration, said:- “We improved this junction 5 years ago and introduced proper crossings for pedestrians. 

However, some motorists deliberately flout the law or else have not noticed the signs prohibiting the left turn. 

Local people have asked us to introduce an all-red phase.

We have listened to them and will be doing so.

However, we will continue to monitor this junction as we need to make sure that traffic congestion is not building up as a result of these changes.

If it does so to unacceptable levels we will then have to review this junction again.”