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 In Dermatology

Novartis has announced that the National Institute for Health and Care Excellence (NICE) has published a positive Final Appraisal Determination (FAD) recommending the use of Cosentyx (secukinumab) alone or in combination with methotrexate by the NHS in England and Wales to treat adults with active and progressive psoriatic arthritis (PsA) when:

  • The person has peripheral arthritis with three or more tender joints and three or more swollen joints, and has not responded to adequate trials of at least two standard disease-modifying antirheumatic drugs (DMARDs), administered either individually or in combination
  • Or the person has had a TNF-alpha inhibitor but their disease has not responded within the first 12 weeks or has stopped responding after 12 weeks
  • Or TNF-alpha inhibitors are contraindicated but would otherwise be considered

Secukinumab is the first in a class of medicines called interleukin-17 (IL-17) inhibitors to be recommended by NICE.

Secukinumab works as a targeted biologic therapy which selectively binds to IL17A and in doing so, stops IL-17A binding to its receptors and causing inflammation. In the FUTURE 2 study, on which the NICE FAD was based, secukinumab successfully demonstrated a rapid onset of action and was significantly superior to placebo in improving signs and symptoms of PsA.

These included health-related quality-of-life measures and improvements in extra-articular manifestations, such as dactylitis (that is, inflammation of the fingers or toes) and enthesitis (that is, inflammation of tendons or ligaments).

Professor Paul Emery, Director of Leeds Institute of Rheumatic and Musculoskeletal Medicine and Leeds Musculoskeletal Biomedical Research Unit, said, ‘Traditionally, anti-TNF biologic drugs have been used to treat psoriatic arthritis, however 30 to 40 per cent of people with psoriatic arthritis fail to respond to anti-TNF therapies, illustrating the clear need for alternative therapies.

‘Secukinumab is the first IL-17A inhibitor which has been shown to significantly improve joint and skin symptoms of psoriatic arthritis, and provides patients with improved physical functioning and quality of life. There is a growing body of evidence that supports the potential of secukinumab to become the standard of care for patients living with this debilitating condition.’

NICE’s decision represents a turning point for psoriatic arthritis patients living in the UK,’ said Judi Rhys, Chief Executive, Arthritis Care.

‘Psoriatic arthritis is a long-term condition that has a huge impact on a patient’s quality of life and we encourage patients to speak to their physicians about their treatment options.’

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