A number of new treatment options for patients with psoriasis and related conditions have been recently approved or are nearing approval for us by the NHS in England and Scotland.
The National Institute for Health and Care Excellence has issued a final appraisal determination recommending secukinumab (Cosentyx) as an option for the treatment of adults with severe plaque psoriasis.
NICE said the treatment should be recommended as an option for some adults with plaque psoriasis if they were unable to take standard systemic therapies and if the drug was provided by Novartis with the agreed patient access scheme discount.
Secukinumab is the first licensed therapy that blocks the IL-17A protein found in increased concentrations in psoriasis-affected skin.
Final technology appraisal guidance for secukinumab is expected over the coming months, after which the NHS has a legal obligation to fund the treatment for eligible patients within three months.
In addition, NICE has backed ustekinumab (Stelara) as a treatment option for patients with active psoriatic arthritis, when the response to previous non-biological disease-modifying anti-rheumatic drug therapy has been inadequate.
Under existing NICE guidance, the drug has been available since 2009 in England – under a patient access scheme for suitable adults – with moderate to severe plaque psoriasis.
According to the new technology appraisal guidance, ustekinumab is recommended as an option, alone or in combination with methotrexate, for treating active psoriatic arthritis in adults only when treatment with tumour necrosis factor alpha inhibitors is contraindicated but would otherwise be considered, or the person has had treatment with one or more TNF-alpha inhibitors.
The decision makes Scottish patients the first in the UK to have access to this new treatment for these linked conditions.
The SMC accepted the treatment for use for patients with moderate-to-severe chronic plaque psoriasis who have failed to respond to or who have a contraindication to, or are intolerant to other systemic therapy including ciclosporin, methotrexate or psoralen and ultraviolet-A light.
It should also be available for those with active psoriatic arthritis who have had an inadequate response with at least two prior DMARD therapies or who have been intolerant to a prior DMARD therapy, said the SMC.