Apremilast for treating moderate to severe plaque psoriasis

Apremilast is recommended as an option for treating chronic plaque psoriasis in adults whose disease has not responded to other systemic therapies, including ciclosporin, methotrexate and PUVA (psoralen and ultraviolet‑A light), or when these treatments are contraindicated or not tolerated, only if:

• 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

• treatment is stopped if the psoriasis has not responded adequately at 16 weeks; an adequate response is defined as:

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

  • a 50% reduction in the PASI score (PASI 50) and a 5‑point reduction in DLQI from start of treatment

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

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.

This guidance is not intended to affect the position of patients whose treatment with apremilast was started within the NHS before this guidance was published. Treatment of those patients may continue without change to whatever funding arrangements were in place for them before this guidance was published until they and their NHS clinician consider it appropriate to stop.