In final draft guidance, NICE has recommended infliximab and adalimumab as treatment options for people with severe, active Crohn’s disease whose condition has not responded to conventional therapy, or who are intolerant of or have contraindications to conventional therapy.
Crohn’s disease is a chronic inflammatory condition of unknown cause affecting the gastrointestinal tract (gut). It is estimated that around 60,000 people in the UK have the disease, with approximately 3,000 (5%) having the most severe forms of the condition. The disease causes parts of the gastrointestinal tract to become inflamed, causing diarrhoea, pain in the abdomen, weight loss and tiredness. Ulcers can form in the wall of the gastrointestinal tract and when they heal the scar tissue makes the tract narrower. Sometimes Crohn’s disease causes the formation of abnormal passageways (fistulas) between parts of the intestine, or between the intestine and the skin. It can also affect other parts of the body, such as the eyes or the joints. NICE recommended that treatment should be started with the less expensive drug (taking into account drug administration costs, required dose and product price per dose). It added that Infliximab is also recommended for adults with active, fistulising Crohn’s disease, and for children and young people aged 6-17 years old with severe, active Crohn’s.
