Biologic eligibility criteria

I was diagnosed with RA almost a year ago. In the time since diagnosis I have started taking methotrexate then Hydroxychloroquine and finally Sulfasalazine. Today I was taken off sulfasalazine because of side effects. I have been told I have to just wait and see what happens to my DAS score. I was told my score would need to go above 5.1 before I would be considered for a biologic. I thought the NICE guidelines stated above 3.2 if 2 or more DMARDS had been tried and failed. Is this another postcode lottery? I suppose I feel frustrated that there are no more options to try until I wait for my last steroid to wear off and see how bad my score gets in 3 months time. 😞 My last few scores have been above 3.2 but not above 5.1 hence my question about the eligibility criteria.


  • frogmorton
    frogmorton Member Posts: 29,018

    Looks like 'they' are right 😕

    Says 5.1 here too.

    There are other conventional DMARDs they could offer you though other than the ones you've already tried.

    Best of luck and ((()))

    Toni x

  • jamieA
    jamieA Member Posts: 605

    Hi @LouH00

    I'm in Scotland and have PsA. In 2021 when I was prescribed the biosimilar Amgevita I was told the criteria was to have tried 2 DMARDS which hadn't worked and to have 3 swollen joints. I will say though that I had to have a very robust discussion with my then rheumatologist and put in writing my unhappiness at the lack of progress in dealing with my condition before the biosimilar was prescribed.

    I saw a new rheumatologist in February this year who told me that they were trying to get patients who required them onto biologics sooner rather than later so that joint damage was minimised.

    I hope you get a resolution soon.

  • LouH00
    LouH00 Member Posts: 8

    Thanks Toni! I’m not being offered any other conventional DMARDs unfortunately. Yes it looks like the Nurse Specialist was right with the level of 5.1 for biologics. When I saw my consultant a couple of months ago she gave me information about adalimumab. It looks like biosimilars (not biologics) are an option for “moderate” RA of between 3.2 & 5.1. Fingers crossed I’m offered this sooner than waiting for my score to go over 5.1 🤞🏻 It doesn’t help that my main issue is my hands and feet. I don’t understand why feet don’t count in DAS score!

  • LouH00
    LouH00 Member Posts: 8

    Hi @jamieA thats a great idea - thank you. My next appointment with my Rheumatologist isn’t until August so contacting the helpline and a letter in the meantime might hopefully trigger some progress. All consultations I have had prior to this week have been about trying to find what works for me to minimise joint damage. Leaving the appointment this week without a new drug to try and being told to wait for a 5.1 DAS score was a bit of a surprise. Hopefully 3 swollen joints is enough…..I definitely have at least that in my hands 😞