Adalimumab is recommended as an option for treating plaque psoriasis in adults when antitumour necrosis factor (TNF) treatment is being considered, only when the condition:
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, and
has not responded to conventional systemic and phototherapy, or these options are contraindicated or not tolerated.
Adalimumab should be discontinued in people whose psoriasis has not responded adequately at 16 weeks. An adequate response is defined as either:
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.
When using the DLQI, healthcare professionals should ensure that when reaching conclusions on the severity of plaque psoriasis they take into account a person's disabilities (such as physical impairments) and linguistic or other communication difficulties. In such cases, healthcare professionals should ensure that their use of the DLQI continues to be a sufficiently accurate measure. The same approach should apply in the context of a decision about whether to continue the use of adalimumab in accordance with section 1.2.