The Surrey Heartlands Integrated Care System Area Prescribing Committee agreed the reviewed and updated rheumatoid arthritis pathway.

The Surrey Heartlands integrated care system Area Prescribing Committee (APC) approve adalimumab, etanercept & infliximab (biosimilars only) as treatment options for treating moderately active Rheumatoid Arthritis in line with NICE TA715.  The current treatment pathway is available below.

Adalimumab, etanercept and infliximab (biosimilars only) for this indication will be considered as RED on the traffic light status (treatment should be initiated and continued by specialist clinicians).  Please prescribe biological products by brand name (as recommended by MHRA).

Primary care prescribers should be aware that their patient is receiving this medicine and ensure that this is recorded on the patient’s medication screen as a hospital-only drug in line with guidance on the PAD. This will also alert the prescriber to potential side effects and interactions with other medicines prescribed in primary care. It will also ensure that GP records, which are accessed by other healthcare providers, are a true and accurate reflection of the patient’s medication.”

The Surrey Heartlands Integrated Care System Area Prescribing Committee recommends the use of infliximab subcutaneous injection or infliximab intravenous infusion. Clinicians & patients will be able to choose the most appropriate product for them at the point of prescribing.

The Surrey Heartlands ICS Area Prescribing Committee have agreed an update of the Rheumatoid Arthritis High Cost DMARDs Drug Treatment Pathway. 

The pathway has been updated following guidance from the Regional Medicines Optimisation Committee in May 2020, in relation to the sequential use of biologic medicines. 

The Medicines and Healthcare Products Regulatory Agency (MHRA) recommends to prescribe biological products by brand name to ensure that substitution of a biosimilar product does not occur when the medicine is dispensed by the pharmacist. Https://www/gov/uk/drug-safety-update/biosimilar-products

Primary care prescriber should ensure that patient medication records include any medicine for which prescribing remains the responsibility of secondary or tertiary care. This will ensure that GP records, which are accessed by other healthcare providers, are a true and accurate reflection of the patient's medication.