3 September 2015 - NICE has published final draft guidance today which does not recommend apremilast (Otezla, Celgene) for adults with active psoriatic arthritis that has either not responded to disease-modifying antirheumatic drug (DMARD) therapy, or where such therapy is not tolerated.

Psoriatic arthritis is an inflammatory disease affecting the joints and connective tissue, and is associated with psoriasis of the skin or nails. It is a lifelong, progressive disorder, ranging from mild synovitis (inflammation of the tissue lining joints such as the hip or shoulder) to severe progressive erosion of the joints.

People with psoriatic arthritis are usually treated initially with non-steroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs) such as methotrexate. Most people whose disease doesn’t respond to these drugs will be treated with a tumour necrosis factor alpha inhibitor (TNF-alfa inhibitor) starting with the lowest-cost drug as recommended in NICE technology appraisal guidance on etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis and golimumab for the treatment of psoriatic arthritis.

For more details, go to: http://www.nice.org.uk/news/press-and-media/nice-issues-draft-guidance-on-apremilast-for-psoriatic-arthritis

MAESTrO Insight: The PBAC rejected a submission to list apremilast (Otezla) on the Pharmaceutical Benefits Scheme (PBS) for use by patients with psoriatic arthritis in March 2015.