Secukinumab for treating moderate to severe plaque psoriasis

Secukinumab is recommended, within its marketing authorisation, as an option for treating adults with plaque psoriasis only when:

• the disease is severe, as defined by a total Psoriasis Area Severity Index (PASI) of 10 or more and a Dermatology Life Quality Index (DLQI) of more than 10

• the disease has failed to respond to standard systemic therapies, for example, ciclosporin, methotrexate and PUVA (psoralen and long‑wave ultraviolet radiation), or these treatments are contraindicated or the person cannot tolerate them

• the company provides secukinumab with the discount agreed in the patient access scheme.

Secukinumab treatment should be stopped in people whose psoriasis has not responded adequately at 12 weeks. Further treatment cycles are not recommended in these people. An adequate response is defined as either:

• a 75% reduction in the PASI score from when treatment started (PASI 75) or

• a 50% reduction in the PASI score (PASI 50) and a 5‑point reduction in DLQI from when treatment started.

People whose treatment with secukinumab is not recommended in this NICE guidance, but was started within the NHS before this guidance was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.

When using the DLQI, healthcare professionals should take into account any physical, sensory or learning disabilities, or communication difficulties, that could affect the responses to the DLQI and make any adjustments they consider appropriate.