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NICE U-turn on Janssen arthritis drug

pharmafile | June 4, 2015 | News story | Sales and Marketing Janssen, NICE, Stelara, psoriasis, uturn 

NICE has performed a U-turn on Janssen’s Stelara and has now recommended the drug for the treatment of psoriatic arthritis.

Stelara (ustekinumab) was rejected by NICE last year after the body concluded that it ‘appeared less effective’ than TNF alpha inhibitors, and was not cost-effective in carrying a list price of £2,147 per 45mg vial.

The drug will now be available for patients for whom treatment with TNF alpha inhibitors has been inadequate. It is also approved under a patient access scheme where it is only recommended if the company provides the 90 mg dose for people who weigh more than 100 kg – at the same cost as the 45 mg dose.

The UK watchdog has also said that treatment with Stelara should be stopped after 24 weeks if it is not working well enough. The drug was a strong financial performer for Janssen in the first quarter of 2015.

It is already approved under a patient access scheme for severe plague psoriasis. Janssen says it has a ‘unique mode of action’ which works by targeting the p40 sub-unit of the interleukin-12 and interleukin-23 proteins. This alters the part of the immune system response thought to be linked to the development of psoriasis and psoriatic arthritis.

Psoriasis affects around 1.8 million people in the UK. Among Psoriasis patients, the prevalence of psoriatic arthritis, a chronic immune-mediated disease characterised by joint inflammation, varies from six to 42 per cent. Psoriatic arthritis can also occur in people without skin psoriasis, but this is less common.

In May NICE recommended the first in a new generation of drugs for skin psoriasis drugs called IL-17A inhibitors – Novartis’ Cosentyx (secukinumab).

AstraZeneca also has an IL-17 inhibitor psoriasis drug in development in the shape of its offering brodalumab. Until recently it was being co-developed with Amgen, but the US firm pulled out of the deal after trials suggested that the treatment could lead to suicidal thoughts.

George Underwood

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