Rheumatology in practice

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NICE: out of step yet racing ahead
RDIP, Volume 7, Number 3.

NICE technology appraisals have been a source of much criticism, not least in the confusion with implementing biologic therapy. In the case of initiating tumour necrosis factor (TNF) blockade, NICE initially adopted the BSR guidelines, based on the principle that TNF should be reserved for resistant patients. With increasing data of the greater efficacy and good long-term safety of these agents, it became clear that the late use of TNF blockade in patients who have more resistant disease (and less ability to improve) is not the optimal method of using these drugs.

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