Secukinumab for treating moderate to severe plaque psoriasis

Secukinumab is recommended as an option for treating plaque psoriasis in adults, 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 treatments and phototherapy, or these options are contraindicated or not tolerated, and

• 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.