New drugs could be made available to rheumatoid arthritis sufferers after NICE reversed its previous decision over their availability.
Sufferers will be given the chance to try a range of drugs after the National Institute for Health and Clinical Excellence (NICE) issued guidance reversing a decision made over the drugs in 2008.
The initial NICE guidance two years ago said that if a patient's first attempt at the anti-TNF (tumour necrosis factor alpha inhibitor) therapy failed they would not be allowed to try a second anti-TNF.
New guidance was issued in March this year suggesting the use of rituximab (MabThera), however this also recommended that adalimumab (Humira), etanercept (Enbrel) and infliximab (Remicade) are only used for research purposes, even for sufferers who had failed on one anti-TNF.
The watchdog also rejected abatacept in that guidance.
In new draft guidance, NICE recommended rituximab as the treatment for patients who have failed on an anti-TNF or who have not responded to other disease-modifying anti-rheumatic drugs.
But it also recommended adalimumab, etanercept, infliximab and abatacept for patients who have failed on one anti-TNF or who have not responded to other disease-modifying anti-rheumatic drugs, and who cannot take rituximab.
It said rituximab should not be given more often than every six months and should only be continued if there is an adequate response.
The other drugs should only be given if there is a good response six months after the start of therapy.