Patients with severe arthritis are to be given access to a new generation of drug on the NHS - a decision hailed by campaigners as a "triumph".
Rheumatoid arthritis affects 400,000 people in the UK
The National Institute for Health and Clinical Excellence (NICE) has approved the so-called "smart drug" MabThera for prescription in England and Wales.
The drug works by specifically targeting one of the key immune system cells involved in rheumatoid arthritis.
It comes after a similar drug, Orencia, was ruled out for prescription.
The final recommendation from NICE means doctors in England and Wales can now prescribe MabThera to NHS patients who have not responded to other therapies.
Rheumatoid arthritis (RA) is a painful and sometimes crippling auto-immune disease that affects an estimated 400,000 people in the UK. It occurs when the immune system attacks the joints, causing swelling and damage of cartilage and bone.
NICE has said that MabThera, which is made by Roche and goes under the generic name rituximab, will be available to NHS patients who fail to improve after first being given the most advanced treatment currently on the market, anti-TNF drugs.
It will be prescribed in addition to another drug, methotrexate.
Arthritis Care chief executive Neil Betteridge said: "It's a triumph. The search for effective treatment can be a long, agonising journey, littered with dashed hopes."
The drug is already freely available to patients with RA in Scotland following a similar decision by NICE's counterpart north of the border, the Scottish Medicines Consortium.
A spokeswoman for the Arthritis Research Campaign, which sponsors research into arthritis, said: "NICE has been in the firing line a lot recently so it should be given credit for approving the use of rituximab.
"This gives patients with severe rheumatoid arthritis who fail on anti-TNF therapy a life-line by making available another treatment option"
NHS trusts now have three months to ensure all qualifying RA patients receive MabThera.
In trials MabThera reduced RA symptoms by more than 50% for more than a third of patients, although some patients reported higher rates of serious infections as a consequence.
A second drug, Humira, which goes under the generic name adalimumab, was approved as a treatment option for psoriatic arthritis, which is associated with the skin disease psoriasis.