The National Institute for Health and Care Excellence (NICE) recommends ixekizumab (Taltz) as a treatment option for active psoriatic arthritis patients with inadequate response, intolerance or contraindication to ≥1 DMARDs.
Ixekizumab is recommended for the treatment of adults with active psoriatic arthritis if the following conditions are fulfilled:
- The drug is used in agreement with NICE's technology appraisal guidance on etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis.
- Patient had no response within the first 12 weeks or had stopped responding after the first 12 weeks to a previous therapy of a TNF-alpha inhibitor.
- TNF-alpha inhibitors are contraindicated but would otherwise be considered.
Recommended dose for ixekizumab is 160 mg (2×80 mg injections) administered subcutaneously at week 0, followed by 80 mg (1 injection) every 4 weeks subsequently. For concomitant moderate-to- severe plaque psoriasis, 160 mg at week 0, followed by 80 mg at weeks 2, 4, 6, 8, 10 and 12, then maintenance dosing of 80 mg every 4 weeks. Therapy should be discontinued if psoriatic arthritis has not responded adequately after 16 weeks. An adequate response is defined as an improvement in at least 2 of the 4 Psoriatic Arthritis Response Criteria, 1 of which must be joint tenderness or swelling score, with no worsening in any of the 4 criteria.
The drug is to be used only when provided by the company in agreement with the commercial arrangement. The recommendations should not affect patients whose treatment with the drug was started before publication of the guidance.
