Janssen’s anti-inflammatory drug Stelara should not be available for NHS use in England and Wales in psoriatic arthritis, according to new guidance.
Cost-effectiveness watchdog the National Institute for Health and Care Excellence (NICE) issued final guidance recommending against extending use of the drug, which has available to treat the skin disease plaque psoriasis since 2009.
Psoriatic arthritis is a more serious, progressive condition that can lead to severe progressive erosion of the joints. It is associated with psoriasis of the skin or nails.
In its review of Stelara (ustekinumab) in this indication NICE acknowledged the drug was clinically effective compared with conventional treatment with disease-modifying antirheumatic drug (DMARD) therapies.
However, the agency’s appraisal committee also concluded that Stelara appeared less effective than already available TNF alpha inhibitors, such as Janssen’s Remicade (infliximab), AbbVie’s Humira (adalimumab) and Amgen’s Enbrel (etanercept). All these drugs are recommended by NICE for use in psoriatic arthritis as part of guidance published in 2010.
Sir Andrew Dillon, NICE chief executive, said: “Whilst recognising the severity of the disease, the Committee concluded that ustekinumab could not be considered a good use of NHS resources.”
These issues were noted in previous negative draft guidance and it appears Janssen and other stakeholders has been unable to overcome the concerns of NICE.
For patients in England and Wales already prescribed Stelara, NICE stated that they have the option to continue treatment until they and their clinicians consider it appropriate to stop.