1.1
Deuruxolitinib can be used, within its marketing authorisation, as an option to treat severe alopecia areata in adults. Deuruxolitinib can only be used if the company provides it according to the commercial arrangement.
1 Recommendations
1.2
Use the least expensive option of the suitable treatments (including deuruxolitinib and ritlecitinib), having discussed the advantages and disadvantages of the available treatments with the person with the condition. Take account of administration costs, dosages, price per dose and commercial arrangements.
What this means in practice
Deuruxolitinib must be funded in the NHS in England for the condition and population in the recommendations, if it is considered the most suitable treatment option. Deuruxolitinib must be funded in England within 30 days of final publication of this guidance.
There is enough evidence to show that deuruxolitinib provides benefits and value for money, so it can be used routinely across the NHS in this population.
Why these recommendations were made
Usual treatment for severe alopecia areata in adults is ritlecitinib. Deuruxolitinib works in a similar way.
Clinical trial evidence shows that deuruxolitinib is more effective than placebo at improving hair regrowth. Deuruxolitinib has not been directly compared with ritlecitinib in a clinical trial. The results of an indirect comparison are uncertain but suggest that deuruxolitinib is likely to work as well as ritlecitinib.
A CYP2C9 genotyping test is needed before starting deuruxolitinib. The company has stated that it will cover the costs associated with the test. Taking this into account, the costs are similar for deuruxolitinib and ritlecitinib. So, deuruxolitinib can be used.
For all evidence, see the committee papers. For more information on NICE's evaluation of ritlecitinib, see the committee discussion section in NICE's technology appraisal guidance on ritlecitinib for treating severe alopecia areata in people 12 years and over.