Active Psoriatic Arthritis (NICE TA433)
Apremilast, alone or in combination with disease-modifying antirheumatic
drugs (DMARDs), is recommended as an option for treating active psoriatic
arthritis in adults only if:
they have peripheral arthritis with 3 or more tender joints and 3 or more swollen joints and
their disease has not responded to adequate trials of at least 2 standard DMARDs, given either alone or in combination and
the company provides apremilast with the discount agreed in the patient access scheme.
Stop apremilast at 16 weeks if the psoriatic arthritis has not shown an adequate response using the Psoriatic Arthritis response Criteria (PsARC), defined as an improvement in at least 2 of the 4 PsARC criteria (including joint tenderness or swelling score) with no worsening in any criteria. If the disease has a Psoriasis Area and Severity Index (PASI) 75 response, a dermatologist should decide whether to continue treatment with apremilast after 16 weeks based on skin response.
Reason for decision: