Jane Kirby

Around 60,000 people with rheumatoid arthritis are being denied access to potentially life-changing drugs, charities said today.

A decision by the National Institute for Health and Clinical Excellence (Nice) could leave sufferers with pain and the possibility of long-term disability. Charities claim this will be a "nail in the coffin" for the treatment of rheumatoid arthritis (RA) in England and Wales.

Patients will not be able to try a second anti-TNF (tumour necrosis factor alpha inhibitor) if their first attempt at anti-TNF therapy fails, according to the Nice decision.

But charities said that moving from one therapy to a second or third has been established practice in the UK for years.

The British Society for Rheumatology Biologics Register shows that 70% of patients will get a good response from a second anti-TNF if the effects of the first start to wane.

Charities will have a chance to appeal against today's decision before final guidance is issued to the NHS in September.

Ailsa Bosworth, chief executive of the National Rheumatoid Arthritis Society, said the move, combined with a Nice decision in April to reject the drug abatacept, meant effective therapies had been cut from five to two.

She added: "This decision is another nail in the coffin for the treatment of RA in England and Wales.

"Nice is ignoring the clinical effectiveness of drugs and ignoring the views of patients and clinicians.

"It is systematically taking away clinically effective and proven treatments from patients and giving them just one roll of the dice when it comes to anti-TNF treatment."

Ros Meek, director of the Arthritis and Musculoskeletal Alliance (Arma), said: "Nice's decision takes away access to a normal and independent life for the many thousands of people battling with the condition.

"It also totally contradicts Lord Darzi's pronouncements in his recent review of the NHS - in particular his focus on patient choice and patient empowerment.

"It's a prescription for pain."

Rob Moots, Arma clinician and professor of rheumatology at Liverpool University, said: "Many patients will be left in astonishing pain, while knowing we haven't explored all the options for them."

Rheumatoid arthritis is an auto-immune disease for which there is no cure.

A spokeswoman for Nice said: "Nice has not yet issued final guidance to the NHS.

"Consultees now have the opportunity to appeal against the draft guidance. "Subject to an appeal being received, guidance is expected in September 2008."