National Institute for Health and Clinical Excellence (NICE)
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NICE guidance recommends treatment for severe plaque psoriasis

The National Institute for Health and Clinical Excellence (NICE) has today (Weds 23 September) published final guidance recommending the use of ustekinumab as a treatment option for adults with severe plaque psoriasis.  It is recommended if the person is assessed as having severe disease that has not responded to standard systemic therapies including ciclosporin, or for adults who cannot use those therapies.  Treatment with ustekinumab should stop if an adequate response has not been achieved by 16 weeks (after the start of treatment) as defined by assessment based on severity of the psoriasis and quality of life. 

Dr Carole Longson, Director of the Health Technology Evaluation Centre at NICE said: “Plaque psoriasis can have a huge impact on an individual, with the condition causing significant discomfort and in severe cases it can be painful.  The characteristic raised red patches of skin covered with silvery scales are commonly seen on elbows, knees or scalp, but in severe cases can cover most of the body. This new guidance recommending ustekinumab will offer hope to adults whose severe plaque psoriasis hasn’t been helped by systemic therapies including ciclosporin, methotrexate and psoralen with long-wave ultraviolet radiation.”

Ustekinumab is recommended on the basis that the manufacturer provides the higher dose needed for people who weigh more than 100 kg at the same total cost as for the lower dose needed for people weighing 100 kg or less.  Healthcare professionals should take into account any physical, sensory or learning disabilities, or other communication difficulties that could affect assessment responses.