NICE has today (19 May) announced that it has recommended two treatments (infliximab and adalimumab) for people with severe Crohn's disease. The guidance approves use of the drugs for people who have not responded to, who are intolerant of, or are unable to take more commonly used therapies to treat the condition.

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. People with Crohn's disease can have recurrent attacks - that is, they have times when their disease flares up and in between they have periods of remission.

The guidance from NICE recommends infliximab and adalimumab as treatment options for adults with a severe, active form of the disease. Treatment should normally be started with the less expensive drug (taking into account drug administration costs, required dose and product price per dose). 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 disease.

Dr Carole Longson, Health Technology Evaluation Centre Director said:

“We are pleased to recommend these treatments for this debilitating, incurable condition. Our review of the evidence indicates that infliximab and adalimumab are clinically and cost effective options for some people with the most severe forms of Crohn's disease, and for those that standard treatments have failed, or are not an option. This guidance will be welcome news to those affected.”

This final guidance now replaces local recommendations across the country; the NHS has three months to start implementing this new guidance.

The guidance is available.

Download PDF version