NICE ready to approve Tremfya for psoriasis

[Fred]

The National Institute for Health and Care Excellence (NICE) have issued final appraisal for Tremfya (guselkumab) to be used  for treating plaque psoriasis in adults.

Quote:

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Guselkumab is recommended as an option for treating plaque psoriasis in adults, only if: the disease is severe, as defined by a total Psoriasis Area and Severity Index (PASI) of 10 or more and a Dermatology Life Quality Index (DLQI) of more than 10 and the disease has not responded to other systemic therapies, including ciclosporin, methotrexate and PUVA (psoralen and long-wave ultraviolet A radiation), or these options are contraindicated or not tolerated and the company provides the drug with the discount agreed in the patient access scheme.

Stop guselkumab treatment at 16 weeks if the psoriasis has not responded adequately. An adequate response is defined as: a 75% reduction in the PASI score (PASI 75) from when treatment started or a 50% reduction in the PASI score (PASI 50) and a 5 -point reduction in DLQI from when treatment started.

For the cost comparison, it is appropriate to compare guselkumab with ixekizumab and secukinumab. Taking into account how many people continue treatment (which affects the costto the NHS), guselkumab provides similar health benefits to ixekizumab and secukinumab at a similar or lower cost. It is therefore recommended as an option for treating plaque psoriasis in the NHS.

Tremfya (guselkumab)

[Turnedlight]

Good, this must be what the nurse hinted at coming along. I’m running out here, the Taltz appears to be a failure so I’ve only got cosentyx left lol!

[Fred]

Good, this must be what the nurse hinted at coming along. I’m running out here, the Taltz appears to be a failure so I’ve only got cosentyx left lol!

Yes I'm in a similar situation. Taltz is the next one for me, but then it's nothing till Tremfya is approved here.

France usually comes after the UK and the UK usually comes after the USA. Next on the list will be Ilumya gets FDA approval for psoriasis and more to follow.

[Fred]

Update: Approval has now been given.

Quote:

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1.1 Guselkumab is recommended as an option for treating plaque psoriasis in adults, only if:

• the disease is severe, as defined by a total Psoriasis Area and Severity Index (PASI) of 10 or more and a Dermatology Life Quality Index (DLQI) of more than 10 and
  
• the disease has not responded to other systemic therapies, including ciclosporin, methotrexate and PUVA (psoralen and long-wave ultraviolet A radiation), or these options are contraindicated or not tolerated and
  
• the company provides the drug according to the commercial arrangement.
  

1.2 Stop guselkumab treatment at 16 weeks if the psoriasis has not responded adequately. An adequate response is defined as:

• a 75% reduction in the PASI score (PASI 75) from when treatment started or
  
• a 50% reduction in the PASI score (PASI 50) and a 5‑point reduction in DLQI from when treatment started.
  

1.3 When using the PASI, healthcare professionals should take into account skin colour and how this could affect the PASI score, and make the clinical adjustments they consider appropriate.
1.4 When using the DLQI, healthcare professionals should take into account any physical, psychological, sensory or learning disabilities, or communication difficulties, that could affect the responses to the DLQI and make any adjustments they consider appropriate.
1.5 If patients and their clinicians consider guselkumab to be one of a range of suitable treatments, including ixekizumab and secukinumab, the least costly (taking into account administration costs and commercial arrangements) should be chosen.
1.6 This recommendation is not intended to affect treatment with guselkumab that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop.

[D Foster]

That's interesting as I have just dropped to 10 weeks for the Stelara as I am losing ground for both P and definitely the PsA so I may be looking at a change in the next 3-6 months.

[Fred]

That's interesting as I have just dropped to 10 weeks for the Stelara as I am losing ground for both P and definitely the PsA so I may be looking at a change in the next 3-6 months.

I got down to 8 weeks before Stelara gave up on me. I'm going for Tatlz next as Cosentyx isn't doing so well for the psoriasis, and I will keep Tremfya on the back burner as it's still the new kid on the block.