All Guidance

Radiographic (Ankylosing Spondylitis) and Non-radiographic Axial Spondyloarthritis (ASp) LSCMMG Recommended Biologic Pathway

This guidance does not replace the SPC’s, which should be read in conjunction with this guidance. 

This guidance does not replace the SPC’s, which should be read in conjunction with this guidance.

Denosumab 120mg injection - Prevention of skeletal-related events (pathological fracture, radiation to bone, spinal cord compression or surgery to bone) in adults with advanced malignancies involving bone.

Treatment of adults and skeletally mature adolescents with giant cell tumour of bone that is unresectable or where surgical resection is likely to result in severe morbidity.

Denosumab 60mg injection - Treatment of osteoporosis in postmenopausal women and in men at increased risk of fracture and treatment of bone loss
associated with long-term systemic glucocorticoid therapy in adult patients at increased risk of fracture

Denosumab as a second-line treatment option for the prevention of Osteoporotic Fragility Fractures

For Treatment of rheumatoid arthritis, discoid and systemic lupus erythematosus, and dermatological conditions caused or aggravated by sunlight in adults Information for prescribers - to be read in conjunction with the SPC

Treatment of active rheumatoid arthritis and active psoriatic arthritis.

Rheumatoid arthritis, severe psoriasis, severe active juvenile idiopathic
arthritis, severe psoriatic arthritis, mild to moderate Crohn’s disease
Unlicensed: Severe Eczema, Lichen Planus, Felty’s syndrome, severe Crohn’s disease

N.B. Not all brands/formulations are licensed for all indications – please refer to individual SPCs

This protocol only applies to the unlicensed indications listed below. Transplant protocols should be followed for licensed indications.

Unlicensed: Severe rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, connective tissue diseases with severe / organ-threatening manifestations, interstitial lung disease (not to be used in idiopathic pulmonary fibrosis IPF), vasculitidies, as maintenance post cyclophosphamide in patients for whom azathioprine is contra-indicated or is inappropriate.

Guidance on consensus approaches to managing Palliative Care Symptoms

Licensed: Severe active rheumatoid arthritis, including juvenile forms, Wilson's disease (hepatolenticular degeneration) in adults and children (0 to 18 years).

The purpose of these guidelines is to provide a quick reference guide for use in primary care summarising information on the diagnosis and management of RLS in primary care. This guidance covers the management of RLS in primary care and gives information about when to refer to secondary care. 

Licensed: Rheumatoid arthritis; ulcerative colitis, Crohn’s disease in adults and children
Unlicensed: Sero-negative spondyloarthropathy including psoriatic arthritis and psoriasis.