Medicines

Here you will find the recommendations we have made about the use of individual medicines in Lancashire.

Guselkumab

Brand: Tremfya®
NICE TA: 521
Indication: Guselkumab for treating moderate to severe plaque psoriasis (NICE TA521)
Disease category: Skin
Commissioning responsibility: CCG
PbR excluded: Yes

Background

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.
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.
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.
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.
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.

Decisions of Lancashire local decision making groups:

NHS Blackburn With Darwen CCG and NHS East Lancashire CCG NHS Blackpool CCG NHS Chorley and South Ribble CCG and NHS Greater Preston CCG NHS Fylde and Wyre CCG NHS Morecambe Bay CCG NHS West Lancashire CCG

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