Just pondering really how rigid the NHS rules are on biologics. At the moment I am not tolerating any of the dmards, they have just started me on a very low dose of lefludomide to see if I can tolerate it and I am also on steroids. So far I've failed on three dmards. I have active disease and swelling across my body however no matter how swollen my joints are my CRP is always normal and a major area of my disease is my feet which aren't counted. I'm in position therefore of only scoring 4.77 when everyone agrees actually my disease is very active. Under the NICE rules I wouldn't qualify. I am just wondering how they can justify passing this test as mandatory when it has recognized flaws?