Otezla (Apremilast) - New Tablet Treatment for Psoriatic Arthritis Approved by NICE

Otezla (Apremilast) is approved for the treatment of psoriatic arthritis in England and Wales.

The National Institute for Health and Care Excellence (NICE) has today published its decision to recommend Otezla (also known by its generic name, Apremilast) as a treatment option for active psoriatic arthritis in adults in England and Wales.

Otezla, given either alone or in combination with disease-modifying antirheumatic drugs (DMARDs), such as methotrexate, is recommended as an option for treating active psoriatic arthritis in adults only if:

• The person has peripheral arthritis with 3 or more tender joints and 3 or more swollen joints, and;
• The person's psoriatic arthritis has not responded to at least 2 standard DMARDs (including methotrexate, sulfasalazine, and leflunomide), given either alone or in combination.

This decision is the conclusion of a NICE Rapid Review and ensures that people with psoriatic arthritis in England and Wales join those in Scotland, where Otezla was approved for the treatment of psoriatic arthritis by the Scottish Medicines Consortium (SMC) in June 2015.

Carla Renton, Information and Communications Manager at the Psoriasis Association remarked: “Psoriatic arthritis is a painful condition that affects up to a third of people with psoriasis. Psoriatic arthritis can cause irreversible damage to the joints, which can have a detrimental effect on people’s lives. This is compounded by low awareness of the condition, which can lead to long delays in correct diagnosis. Today’s positive news offers a new treatment option for people living with psoriatic arthritis. The introduction of Otezla on the NHS is good news for patients with this debilitating condition.”

How does Otezla work?

It is not known exactly how Otezla works in psoriatic arthritis. However, it is known that Otezla inhibits (i.e. stops it from working as it usually does) an enzyme known as phosphodiesterase 4, or PDE4. PDE4 controls the inflammatory action within a cell, which can affect the level of inflammation associated with psoriatic arthritis. Helping to control this inflammation can lead to an improvement in symptoms for people with psoriatic arthritis.

How is Otezla used?

Otezla is taken orally in tablet form twice a day. The dose is gradually increased over the first five days, until the patient is taking the full 30mg twice a day from day six onwards.

Otezla can be taken on its own, or with methotrexate.

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