Last week the National Institute for Health and Clinical Excellence (NICE) issued an update on the use of biologic agents. It has taken advice from specialists and reversed previous judgements on the use of abatacept and tocilizumab. These may now be used after the failure of TNF blockade in patients who have had a reaction to rituximab or where this is contraindicated. A previous ruling added certolizumab pegol to the list of TNF blockers.
NICE conceded that failure to respond to one biologic does not preclude response to another.
While the new guidance does not give rheumatologists a free rein in prescribing it does widen the choice of biologics, and also acknowledges that there is poor cause to treat all of them as equivalent. We have always argued that TNF antibodies (the drugs ending in "ab" may work in a slightly different way to receptor blockers (whose names end in "cept"), and also that there is no reason to suppose that B-cell or T-cell inhibition (rituximab and abatacept) and interleukin-6 antagonism (tocilizumab) work in an identical way.
Rheumatologists facing those patients who had previously run out of options can rejoice!
(Added 3rd July 2010)
To see our poster ""Impact of a community-based rheumatology service on a hospital department" (Bamji & Lane, Rheumatology 2010, poster 96, 21st April 2010) click here
Added 26th April 2010
A BMJ newsflash has a useful link to a 12 minute video on the Alexander Technique. The research, from Southampton, suggests that six lessons may be very helpful in managing chronic back pain.
Added 18th December 2008
BBC's Timewatch programme, broadcast on Saturday November 1st, BBC2) was about the last days of the First World War and will be introduced by Michael Palin. Dr Bamji, who is Curator of the Queen Mary's Hospital Archives, discussed the issues of injury and disfigurement, ensuring that our memories of the 90th anniversary of the end of the war will not be confined to remembrance of those who died.
Added 14th November 2008
This BBC Radio 4 series, introduced by Dr Mark Porter, keeps listeners up to date with modern practice and gives them an insight into the workings of professionals. Mark and producer Paula McGrath interviewed Dr Bamji and physiotherapist Julie Abrahams today at Erith Hospital and listened in to some patient consultations. The programme were broadcast on Tuesday 22nd April at 9pm and repeated Wednesday 23rd April at 4.30pm. Click here to listen
Dr Bamji with producer Paula McGrath and Mark Porter
Added 28th March 2008
Nine members of the Department attended the "Hospital Doctor" Awards 2005 on November 10th at the Hilton Hotel, Park Lane. Up against stiff competition we were pipped to "Rheumatology Team of the Year" by the team from Southampton led by Professor Cyrus Cooper, but had an enjoyable evening nevertheless! It was a great boost for the department to feel that our hard work had been recognised at national level.
(Top) The team; (below left) Dr Bamji arriving for dinner ; (below right) Catriona Howse and Dr Cheung talking to Dr Patrick Gordon from King's College Hospital, a member of the third shortlisted team. Pictures from "Pressgang"
On 13th February 2006 the team were presented with a cheque for £1000 by Jo Lovett from Pfizer Ltd, who were the team's sponsors at the event
Updated 4th September 2005
Plants still provide some of our medicines today. On the left is the willow, from which aspiring is derived; on the right, the pepper plant, Capsicum, from which capsaicin cream, used as a counter-irritant in chronic pain, is made.
Page last updated 3rd July 2010