Cimzia & Ilumetri - NICE Approves Two New Biologic Treatments for Psoriasis

The injectable treatments, Cimzia (Certolizumab Pegol) and Ilumetri (Tildrakizumab), get the go ahead from NICE.

The National Institute for Health and Care Excellence (NICE) has today published its decision to recommend the biologic medicine Cimzia (also known by its generic name, Certolizumab Pegol) as a treatment option for adults with severe plaque psoriasis in England and Wales.

NICE has also published its decision to recommend another biologic medicine, Ilumetri (also known by its generic name, Tildrakizumab) as a treatment option for adults with severe plaque psoriasis in England and Wales.

Cimzia or Ilumetri may be prescribed if:

• The patient's psoriasis is severe, as defined by a total Psoriasis Area and Severity Index (PASI) of 10 or more and a Dermatology Life Quality Index (DLQI) of more than 10 and;
• The patient's psoriasis has not responded to other systemic treatments, (including ciclosporin, methotrexate and phototherapy), or they cannot tolerate these treatments.


You can find out more about Cimzia and Ilumetri below.

Cimzia (Certolizumab Pegol)

How does Cimzia work?

Cimzia blocks tumour necrosis factor-alpha (TNF alpha), a chemical ‘messenger’ in the immune system that signals other cells to cause inflammation. There is too much TNF alpha in the skin of people with psoriasis which causes inflammation and can lead to tissue and joint damage. TNF alpha can also lead to increased activity of the immune system by switching on certain white blood cells in the body, called T Cells. Once T cells become overactive they can trigger inflammation and other immune responses, encouraging the development of psoriasis.

Cimzia helps lower the amount of TNF alpha to more normal levels, and switches off the inflammatory cycle of psoriasis. This leads to improvement in symptoms for many people who take it.

How is Cimzia used?

Individuals take Cimzia at home by giving themselves an injection under the skin via a pre-filled ‘pen’ device. Most people will be trained by a nurse to give the injection to themselves. After the ‘starting dose’ of two injections (400mg) at weeks 0, 2 and 4, patients take one injection (200mg) of Cimzia every two weeks. Cimzia can be prescribed by itself or is sometimes used in combination with methotrexate.

People taking Cimzia will have regular blood tests every three to six months - usually carried out by Dermatology or Rheumatology Nurses, or by their own GP - to monitor for infections or other possible effects of the treatment. People taking Cimzia should have an annual flu jab, but should check with a doctor or nurse before having any other vaccinations or taking other medication.

For more information on Cimzia, have a read of our information sheet.

Ilumetri (Tildrakizumab)

How does Ilumetri work?

Ilumetri blocks the activity of interleukin 23 (IL-23), a chemical ‘messenger’ in the immune system that signals other cells to cause inflammation. In people with psoriasis the immune system is overactive and creates too much inflammation, which leads to the development of psoriasis symptoms. Ilumetri is very precise and binds to a specific part of the IL-23 messenger, called p19. This then blocks IL-23 from sending out the inflammation signals and processes, preventing some of the inflammation from occurring and leading to an improvement in psoriasis for some people who take it.

How is Ilumetri used?

Ilumetri is taken as an injection under the skin via a pre-filled syringe. Most people will be trained by a nurse to give the injection to themselves. The second dose is taken four weeks after the first, but after that Ilumetri is usually taken every 12 weeks thereafter.

People taking Ilumetri will have regular blood tests every three to six months – usually carried out by Dermatology nurses, or by their own GP, to monitor for infections or other possible effects of the treatment. People taking Ilumetri are more at risk of infections and so should have an annual flu and pneumococcal vaccination.

However, not all vaccinations are safe in people taking Ilumetri and ‘live’ vaccinations should be avoided for four weeks before treatment, during treatment and for 12 months afterwards. Check with a doctor, nurse or pharmacist before having any vaccinations or taking other medication if you are not sure.

For more information on Ilumetri, have a read of our information sheet.