The National Institute for Health and Care Excellence (NICE) has published a positive Final Appraisal Determination (FAD) which backs NHS use of Novartis’ Cosentyx (secukinumab) in adults with active and progressive psoriatic arthritis (PsA).

PsA is an inflammatory disease affecting a range of joints and connective tissue, estimated to occur in around 117,000 people in the UK. The condition can affect any age and gender, although it occurs most commonly in people aged between 40 - 50 years old.

The cost watchdog is recommending use of Cosentyx (secukinumab) when a patient 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.

It can also be funded for use in those who have had a TNF-alpha inhibitor but have not responded to treatment within the first 12 weeks or have stopped responding after 12 weeks, or when TNF-alpha inhibitors are contraindicated but would otherwise be considered.

Cosentyx - the first in a class of medicines called interleukin-17 (IL-17) inhibitors to be recommended by the institute in this setting - is a targeted biologic therapy that selectively binds to IL17A and in doing so, stops it from binding to its receptors and causing inflammation.

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

“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.”

“The NICE recommendation recognises the clinical importance of secukinumab, which has the potential to be the new standard of care for patients living with psoriatic arthritis” said Dimitrios Georgiopoulos, ‎Novartis Pharmaceuticals UK’s chief scientific officer.

“We are now also one step closer to addressing the disparity of care for patients in the UK, given patients in Scotland have been benefiting from access to secukinumab since August 2016 following SMC approval. We now need to work closely with the National Health Service to ensure patients are able to rapidly access secukinumab.”

In July 2015 NICE approved Cosentyx for restricted use within the National Health Service (NHS) in England and Wales to treat adults with moderate to severe plaque psoriasis and in August 2016 for active ankylosing spondylitis (AS) in adults when non-steroidal anti-inflammatory drugs or TNF-alpha inhibitors haven’t worked or aren’t suitable.

In Scotland, the drug is routinely available on the NHS to treat adult patients with moderate to severe plaque psoriasis, adult patients with active AS who have responded inadequately to conventional therapy and to treat PsA in adults when the response to previous disease-modifying anti-rheumatic drug (DMARD) therapy has been inadequate.