14 September 2021

NICE Recommends Treatment for People with Juvenile Idiopathic Arthritis

NICE has today (9 September 2021) published final draft guidance which recommends tofacitinib (also known as Xeljanz and made by Pfizer) as an option for treating active polyarticular juvenile arthritis and juvenile psoriatic arthritis in people 2 years and older.

The treatment is available for young people whose arthritis has not responded well enough to disease-modifying antirheumatic drugs (DMARDs) and only if:

  • a tumour necrosis factor (TNF)-alpha inhibitor is not suitable or does not control the condition well enough, and
  • the company provides tofacitinib according to the commercial arrangement

Clinical evidence shows that tofacitinib is effective when compared with a placebo and indirect comparisons suggest it has a similar effect to other treatments for the same indication.

Active polyarticular juvenile arthritis and juvenile psoriatic arthritis are types of juvenile idiopathic arthritis. Juvenile idiopathic arthritis is an inflammation of the joints that begins in people under 16 years of age where the cause or trigger is uncertain or unknown. In total about 3,000 in England have juvenile idiopathic arthritis.

There are more than 1,000 people in England who would be eligible for treatment with tofacitinib.

Tofacitinib is the second drug which has been recommended as part of a new approach to the cost comparison fast track appraisal process being piloted by NICE.

The pilot programme works by using a subset of the appraisal committee to assess low-risk treatments, comparing them to similar therapies that have already been appraised by NICE. This sub-committee is then able to make a recommendation without requiring a full committee meeting.

Meindert Boysen, deputy chief executive and director of the Centre for Health Technology Evaluation at NICE said: “I am very pleased NICE has been able to recommend tofacitinib for young people with this form of arthritis. Tofacitinib has the potential to help young people with this condition be more able to take part in some physical activities and sports, which will significantly help improve their quality of life.”

“I am also pleased the company worked with NICE and our independent appraisal committee to supply evidence which meant we could not only make a positive recommendation, but one which fast-tracks access for this group of people in the NHS.”