1.1
Tocilizumab in combination with methotrexate is recommended as an option for the treatment of rheumatoid arthritis in adults if:
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[this part of the recommendation has been replaced by the recommendations in the NICE technology appraisal guidance on adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed]
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the disease has responded inadequately to DMARDs and a TNF inhibitor and the person cannot receive rituximab because of a contraindication to rituximab, or because rituximab is withdrawn because of an adverse event, and tocilizumab is used as described for TNF inhibitor treatments in the NICE technology appraisal guidance on adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a TNF inhibitor, specifically the recommendations on disease activity or
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the disease has responded inadequately to one or more TNF inhibitor treatments and to rituximab
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and the manufacturers provide tocilizumab (branded or biosimilars) with the discount agreed as part of the patient access scheme.