Anti-TNF and Leflunomide

englishrose

I have put a post on the forum but thought you may be able to help me.
Are you aware of a rule that before you can be considered for Ant-TNF you must first try Leflunomide?
I am having a battle with my Rheumatologist who keeps changing his mind and saying you nust first do this. This has been a long running saga. Any help much appreciated.
Jane

helpline_team

Dear Jane,

Thank you for your posted message. It sounds as if this has been a frustrating and difficult time for you. It is worth mentioning here that we are not medically trained. According to NICE guidance you must fail on Methotrexate and one other disease modifying drug (DMARD), e.g. Leflunomide before you are eligible to try an anti- TNF medication. You also need to be a certain level on your disease activity score (DAS28).

Please find as follows the link to the NICE guidance for rheumatoid arthritis which may be helpful in explaining this: http://www.nice.org.uk/nicemedia/pdf/CG79NICEGuideline.pdf

Also National Rheumatoid Arthritis Society (NRAS) has some information on disease activity score: http://www.rheumatoid.org.uk/article.php?article_id=475

We have a great deal of information on our website also, if you would like to speak to someone, I would encourage you to call our free phone helpline number: 0808 800 4050

Best wishes
Jaslin

englishrose

helpline_team wrote:

Dear Jane,

Thank you for your posted message. It sounds as if this has been a frustrating and difficult time for you. It is worth mentioning here that we are not medically trained. According to NICE guidance you must fail on Methotrexate and one other disease modifying drug (DMARD), e.g. Leflunomide before you are eligible to try an anti- TNF medication. You also need to be a certain level on your disease activity score (DAS28).

Please find as follows the link to the NICE guidance for rheumatoid arthritis which may be helpful in explaining this: http://www.nice.org.uk/nicemedia/pdf/CG79NICEGuideline.pdf

Also National Rheumatoid Arthritis Society (NRAS) has some information on disease activity score: http://www.rheumatoid.org.uk/article.php?article_id=475

We have a great deal of information on our website also, if you would like to speak to someone, I would encourage you to call our free phone helpline number: 0808 800 4050

Best wishes
Jaslin

Jaslin, Thank you so much for your reply. I have read both the articles you suggested and now am very confused as to what is happening to me. I have had 2 DAS score assessments giving a result of 6.33. I also comply with the NICE guidline in that I am on MTX and have tried two other desease modifying drugs. And yet after taking nearly 4 months (during which time I now have additional areas of inflamation i.e feet, ankles and wrist) and yet they now say I have first to try a course of Leflunomide.
I have written to my Consultant explaining ny concers.
Agaon, many thanks and watch this space!
Jane

helpline_team

Dear Jane,

This is the kind of situation where people often arm themselves by involving their local MP if they meet continued resistance to their access to anti tnf treatments. If you need further information on this see the public policy and campaigns area of our website.

Hope that helps

Guy