Ipswich and East Suffolk CCG
North East Essex CCG
East Suffolk and North East Essex NHS Foundation Trust

 
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13 Skin
13-05-03-02 Cytokine modulators (biologic therapies) - psoriasis

Brodalumab
Formulary
Link  NICE TA511 Brodalumab for treating moderate to severe plaque psoriasis
 

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Certolizumab pegol Cimzia 200mg/ml injection
Formulary
Link  NICE TA574 Certolizumab pegol for treating moderate to severe plaque psoriasis
 

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Etanercept
Formulary

Consultant dermatologists & rheumatologists only


Hospital only guidance

Prescribing etanercept

  • All prescriptions for etanercept must be prescribed by brand name
  • Existing patients currently receiving etanercept will continue to be prescribed Enbrel® unless a switch has been agreed. 
  • New patients will be prescribed Benepali® 

Should patients experience unexpected side effects, lack of tolerance or a symptom flare while using the biosimilar, the originator product i.e Enbrel® should be used

Link  NICE TA103: Psoriasis - efalizumab and etanercept
 

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Guselkumab Tremfya
Formulary

Specialist use only for moderate to severe plaque psoriasis

Homecare delivery for subcutaneous injection

Link  NICE TA521 Guselkumab for treating moderate to severe plaque psoriasis
 

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Infliximab Inflectra®
Formulary

Hospital only guidance

Prescribing Infliximab

  • All prescriptions for infliximab must be prescribed by brand name
  • All existing patients currently receiving infliximab will continue to be prescribed Remicade® or Remsima® unless a switch to Inflectra®has been agreed
  • New patients will be prescribed inflectra®

Should patients experience unexpected side effects, lack of tolerance or a symptom flare while using the biosimilar, the originator product i.e Remicade® should be used

Link  NICE TA134: Infliximab for psoriasis
 

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Ixekizumab
Formulary
Link  NICE TA442 : Ixekizumab for treating moderate to severe plaque psoriasis
 

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Risankizumab Skyrizi
Formulary
Link  NICE TA596 Risankizumab for treating moderate to severe plaque psoriasis
 

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Secukinumab
Formulary
Link  NICE TA350: Plaque Psoriasis
Link  NICE TA445: Secukinumab for treating active psoriatic arthritis after inadequate response to DMARDs
 

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Tildrakizumab Ilumetri 100mg/ml injection
Formulary
Link  NICE TA575 Tildrakizumab for treating moderate to severe plaque psoriasis
 

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Ustekinumab
Formulary

MHRA:Risk of exfoliative dermatitis

Link  NICE TA180: Psoriasis - ustekinumab
Link  NICE TA340: Ustekinumab for treating active psoriatic arthritis
Link  NICE TA455 : Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young peopl
Link  NICE TA456 : Ustekinumab for moderately to severely active Crohn’s disease after previous treatment
 

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Adalimumab
Formulary

Any new prescription initiated for adalimumab must be for the biosimilar.

NHS England framework for biosimilar adalimumab for the Eastern Region is as follows:

1st line biosimilar drug=Imraldi (citrate containing injection)

2nd line biosimilar drug=Amgevita (non-citrate injection)

The originator drug Humira must not be initiated in any patient.  Patients who develop an injection site reaction repeatedly must be switched to the non-citrate injection Amgevita.  Patients who develop a system reaction to any biosimilar adalimumab product must be reviewed by the MDT for suitability of adalimumab and must not be switched back to Humira without MDT,  Pharmacy and CCG approval.  An algorithm is being developed to support this (01/07/2019).

Link  NICE TA146: Adalimumab for the treatment of adults with psoriasis
Link  NICE TA392: Adalimumab for treating moderate to severe hidradenitis suppurativa
 

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