Sarilumab for Previously-Treated Moderate or Severe Rheumatoid Arthritis: An Evidence Review Group Perspective of a NICE Single Technology Appraisal

  title={Sarilumab for Previously-Treated Moderate or Severe Rheumatoid Arthritis: An Evidence Review Group Perspective of a NICE Single Technology Appraisal},
  author={I{\~n}igo Bermejo and Shijie Ren and Emma L. Simpson and Mark Clowes and David L. Scott and Adam Young and M. D. Stevenson},
As part of its single technology appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer (Sanofi Genzyme) of sarilumab (SAR; Kevzara®) to submit evidence of its clinical effectiveness and cost-effectiveness for previously treated moderate or severe rheumatoid arthritis (RA). The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as the independent Evidence Review Group… 
2 Citations
Systematic Literature Review of Economic Evaluations of Biological Treatment Sequences for Patients with Moderate to Severe Rheumatoid Arthritis Previously Treated with Disease-Modifying Anti-rheumatic Drugs
A lack of high-quality evaluations assessing bDMARD sequences for patients with moderate to severe rheumatoid arthritis previously treated with DMARDs is identified, although some improvements were made in the reporting and modelling of patients’ pathways in studies published after 2010.
Novel corona virus (COVID-19) pandemic: current status and possible strategies for detection and treatment of the disease.
A comprehensive analysis of the recent developments of the COVID-19 pandemic has been provided, including the structural characterization of the virus, the current worldwide status of the disease, various detection strategies, drugs recommended for the effective treatment, and progress of vaccine development programs by different countries.


Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a tumour necrosis factor inhibitor: a systematic review and economic evaluation.
Evidence from RCTs suggests that RTX and ABT are more effective than supportive care, and the ICER for ABT compared with RTX is over £100,000 (per QALY); however, there remain uncertainties in the TNF inhibitors' effectiveness and cost-effectiveness.
Efficacy and safety of sarilumab monotherapy versus adalimumab monotherapy for the treatment of patients with active rheumatoid arthritis (MONARCH): a randomised, double-blind, parallel-group phase III trial
Sarilumabmonotherapy demonstrated superiority to adalimumab monotherapy by improving the signs and symptoms and physical functions in patients with RA who were unable to continue MTX treatment.
Sarilumab, a fully human monoclonal antibody against IL-6Rα in patients with rheumatoid arthritis and an inadequate response to methotrexate: efficacy and safety results from the randomised SARIL-RA-MOBILITY Part A trial
Sarilumab improved signs and symptoms of RA over 12 weeks in patients with moderate-to-severe RA with a safety profile similar to reports with other IL-6 inhibitors.
Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for the treatment of rheumatoid arthritis not previously treated with disease-modifying antirheumatic drugs and after the failure of conventional disease-modifying antirheumatic drugs only: systematic review
A mathematical model was constructed to simulate the experiences of hypothetical patients and bDMARDs appear to have cost per QALY values greater than the thresholds stated by the National Institute for Health and Care Excellence for interventions to be cost-effective.
American College of Rheumatology. Preliminary definition of improvement in rheumatoid arthritis.
The results suggest that the definition of improvement presented is statistically powerful and does not identify a large percentage of placebo-treated patients as being improved, which the authors hope will be used widely in RA trials.
The incidence of rheumatoid arthritis in the United Kingdom: results from the Norfolk Arthritis Register.
The first data on the incidence of RA based on a prospective population-based register is provided and it is shown that RA was rare in men aged under 45 yr, plateaued to age 75 yr, and fell in the very elderly.
Development and validation of the European League Against Rheumatism response criteria for rheumatoid arthritis. Comparison with the preliminary American College of Rheumatology and the World Health Organization/International League Against Rheumatism Criteria.
EULAR response criteria showed better construct and discriminant validity than did the ACR and the WHO/ILAR response criteria for RA and the World Health Organization and International League Against Rheumatism criteria.
Trends in cardiovascular mortality in patients with rheumatoid arthritis over 50 years: a systematic review and meta-analysis of cohort studies.
The results show that RA is associated with a 60% increase in risk of CV death compared with general population, and targeting a reduction in CV mortality should still be considered as a major issue in RA.