biologic therapies include the tumour necrosis factor (TNF) alpha inhibitors, (etanercept, infliximab and adalimumab), rituximab and anakinra
NICE suggest that:
on the balance of its clinical benefits and cost effectiveness, anakinra is not recommended for the treatment of rheumatoid arthritis (RA), except in the context of a controlled, long-term clinical study
patients currently receiving anakinra for RA may suffer loss of wellbeing if their treatment were discontinued at a time they did not anticipate. Therefore, patients should continue therapy with anakinra until they and their consultant consider it is appropriate to stop
do not offer the combination of tumour necrosis factor- alpha inhibitor therapy and anakinra for RA
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