Hi!
The provisional decision from NICE has been released. From the NRAS front page:

The National Rheumatoid Arthritis Society (NRAS) has expressed their frustration at NICE’s provisional decision not to allow patients with rheumatoid arthritis to routinely switch from one Anti-TNF drug to another. This is the second time NICE has appraised the sequential effectiveness of multiple biologic therapies following NRAS’s successful appeal of negative NICE guidance on switching in 2007.
Over time, some patients find that whichever Anti-TNF they have been taking becomes less effective and have found benefit from being able to switch to another Anti-TNF.

This is a very worrying situation for many and I do wonder where NICE come up with their facts! I am already on my second anti-TNF having started on Infliximab (Remicade) in January 2003 but due to the loss of effectiveness after about 12 months I was moved onto Enbrel (Etanercept) in June 2004. In those last five years my quality of life has seen a significant improvement. I am more mobile (although still limited due to previous joint damage), I have less pain (apart from existing damage), hopefully ongoing joint damage will have been slowed down by the treatment (and I do feel this to be the case), and for the first time in 21+ years I actually believe that the disease has been controlled. In the last 12 months to a lesser extent as I think perhaps the Enbrel is losing it's efficacy. If this provisional decision becomes a reality the only remaining treatment option open to me will be Rituximab. I was keeping this in reserve for a very rainy day!!

I have at least had two anti-tnf therapies, others will be less fortunate. Certainly, for me, the switch has been beneficial and I'm sure would be equally so for others.

Lyn x

This is the point Jenni. It is the sickest people who do get offered them and their tolerance to infection is lowered before they even start the new drug. It is not tested on a level playing field. The evidence is in the improved quality of life in Lyn and others like her and I am so upset that the right to switch may/is being denied. After all, if any other medication in any other field no longer was effective there would be no hesitation in switching. very sad.

Eleanor x

I am in exaclty the same position as Lynw. I'm on my second anti-tnf, Enbrel, which I feel is beginning to work less well. My consultant mentioned Rituximab to me last year, so will have to wait and see how things go this year.

Lyn