Cost regulators for National Health Service drugs in England are now endorsing the use of Janssen’s Stelara as a cost-effective option for treating psoriatic arthritis in specific circumstances.

Back in May the National Institute for Health and Care Excellence issued guidance rejecting the drug’s use for treating active psoriatic arthritis in adults who had failed to adequately respond to non-biological disease-modifying antirheumatic drug (DMARD) therapy.

However, a subsequent rapid review of these guidelines - incorporating a patient access scheme agreed between Janssen and the Department of Health under which the 90mg dose of Stelara is provided at the same cost as the 45mg dose for patients who weigh more than 100kg and need the higher dose - has driven a change of heart.

NICE’s Appraisal Committee is now proposing to support reimbursement for the drug when used as an option, alone or in combination with methotrexate, for treating the condition when treatment with TNF-alpha inhibitors is contraindicated but would otherwise be considered or the person has had treatment with one or more TNF-alpha inhibitors.

Commenting on the decision, Iain McInnes of the Glasgow Royal Infirmary, said “one of the challenges that we face as clinicians, is that current psoriatic arthritis treatments do not work for every patient, or if they do, they may stop working over time. We are therefore delighted that we may be able to offer our patients another effective treatment option on the NHS, which works in a different way to other licenced therapies.”