NICE recommends Lilly’s Baricitinib (Olumiant) to treat rheumatoid arthritis

Eli Lilly and Company announced that baricitinib (Olumiant), with methotrexate, is to be recommended by the National Institute for Health and Care Excellence (NICE) as an option for treating severe active rheumatoid arthritis in adults:

• whose disease has responded inadequately to intensive therapy with conventional disease-modifying antirheumatic drugs (DMARDs)
• who cannot have other DMARDs, including at least one biological DMARD, and if they cannot have rituximab

Baricitinib can also be used as a monotherapy for people who cannot take methotrexate because it is contraindicated or because of intolerance.

Novel treatment

NICE published its Final Appraisal Determination (FAD) on the use of baricitinib on Thursday 29th June 2017. The FAD notes that baricitinib is a novel treatment with a different mode of action to biological DMARDs and unlike biological DMARDs it is given as a tablet rather than an injection. It is one of a new class of medicines called JAK inhibitors which interfere with the cell signalling of one or more of the Janus kinase family of enzymes (JAK1, JAK2, JAK3, TYK2) which are associated with inflammatory and immune conditions.

If there is no appeal, the final NICE Guidance will be published by NICE in the next few weeks and routine NHS England funding will be available for baricitinib. All health boards in Wales are required to make a NICE medicine available no later than two months from the date of the first publication of the NICE final appraisal determination (FAD), rather than waiting for the final Technology Appraisal guidance published after the appeal period.