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Latest
Psoriasis Association News
| NICE
technology appraisal guidance 199 – Etanercept, infliximab
and adalimumab for the treatment of psoriatic arthritis
On 25th August 2010, NICE replaced its existing guidance regarding
psoriatic arthritis – etanercept and infliximab, and psoriatic
arthritis – adalimumab. NICE regularly reviews each piece
of guidance it issues. The review of these treatments for psoriatic
arthritis has resulted in an extension to the guidance:
Etanercept, infliximab and adalimumab are all
recommended for the treatment of active and progressive psoriatic
arthritis, based on specific criteria. Treatment choice should
be started with the least expensive drug (taking into account
drug administration costs, required dose and product price per
dose).
The guidance recommends that treatment should be discontinued
if people’s disease does not show an adequate response on
the Psoriatic Arthritis Response Criteria (PsARC) at 12 weeks.
Healthcare professionals should also consider continuing treatment
if people’s skin disease has a Psoriasis Area and Severity
Index (PASI) 75 response at 12 weeks in the absence of adequate
PsARC response. This assessment should be done by a dermatologist
to determine whether continued treatment is appropriate on the
basis of the skin response alone.
Etanercept, infliximab and adalimumab are recommended
for the treatment of adults with active and progressive psoriatic
arthritis when the following criteria are met:
*The person has peripheral arthritis with three or more tender
joints and three or more swollen joints, and
* The psoriatic arthritis has not responded to adequate trials
of at least two standard disease-modifying antirheumatic drugs
(DMARDs), administered either individually or in combination.
Whilst NICE recommends that treatment should begin with the least
expensive drug, this can differ depending on agreements
between your local health authority and the pharmaceutical company.
Cost variations differ also as the drugs each have different doses,
for example, adalimumab is a set dose irrespective of weight,
whereas infliximab is a weight dependent dose. The NICE committee
considered that there was insufficient evidence of superiority
of any one agent over the others.
The Secretary of State and the Welsh Assembly Minister for Health
and Social Services have issued directions to the NHS on implementing
NICE technology appraisal guidance. When a NICE technology
appraisal recommends use of a drug or treatment, or other technology,
the NHS must provide funding and resources for it within 3 months
of the guidance being published. If the Department of
Health issues a variation to the direction, details will be available
on the NICE website. The NHS is not required to fund treatments
that are not recommended by NICE.
For
further info, please visit: http://guidance.nice.org.uk/TA199
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Response
to research covered by the BBC: Women
beer drinkers "increase risk of psoriasis"
This
large study of female nurses has highlighted some interesting
findings regarding women and psoriasis. This most recent study
has identified a link between women drinking beer and the onset
of psoriasis, however, further research is required in order to
find out the reason for this. Whilst anecdotally some people with
psoriasis have found benefit from dietary changes, this has not
been replicated in larger clinical trials. The Psoriasis Association
therefore advises anyone thinking of changing their diet to first
speak to a dietitian or GP in order to ensure they are eating
a healthy, varied diet.
Alcohol intake should be sensible and moderate following government
guidelines for the rest of the population, or following advise
from a dermatologist should you be on medication such as methotrexate
or acitretin.
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NEW
BBC ONE SHOW RECRUITING VOLUNTEERS
The
BBC are currently recruiting volunteers for their new health show
and ask -
Are you suffering from a skin condition that isn’t
responding to treatment?
Are you unsure what this skin condition is?
Is your condition affecting the way you look, your confidence
and your emotional wellbeing?
Do you want to know what’s wrong with you and get treatment?
Maverick Television, makers of Embarrassing Bodies are producing
a brand-new health show for BBC One.
Please email us with a detailed description of your health problem,
photos, plus your contact details.
Email: whatswrongwithme@mavericktv.co.uk
Phone Number: 0207 874 6660
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FUNDRAISING
Alan
Bentley
is
walking Wainwright's Coast to Coast trail (all 192.5 miles of it!) to
raise money for the Psoriasis
Association. His challenge starts in early October,
and of course we wish him the best of luck! Show
your support and sponsor him at his JustGiving
page.
Cara
Lewis
is
participating in this year's Mayor
of London's Skyride to raise money for the Psoriasis
Association. It takes place on Sunday 5th September
and sounds like it will be a lovely day! Please
sponsor her at her JustGiving
page.
If
you would like to raise money for the Psoriasis Association, please
get in touch!
PsAPods
LAUNCH
The
Psoriasis Association is delighted to announce
the launch of 5 new podcasts regarding Psoriatic
Arthritis. The podcasts take the form of interviews, with Dr
Philip Helliwell, rheumatology nurse Charlie Davis, and patient Elizabeth
Maw, to cover all aspects of the condition; symptoms, treatments, everyday
living, medical appointments, and upcoming research in the area. These
are essential resources for anyone; newly
diagnosed, living with the condition, or simply wanting to find out
more about Psoriatic Arthritis.
Click
here to download the PsAPods FREE.
Do
you live in Scotland and have Psoriasis or Psoriatic Arthritis?
The
School of Pharmacy and Life Sciences at Robert Gordon University are
carrying out research looking at patient perceptions of, and satisfaction
with their Psoriasis. The research is being carried out using an online
survey and takes between 10 and 15 minutes to complete:
www.rgu.ac.uk/psoriasis-study-Aberdeen
The 'Skin' Exhibition at the Wellcome 10th June - 26th
September 2010
The 'Skin' exhibition invites you to
re-evaluate the largest and probably most overlooked human organ. We
will consider the changing importance of skin, from anatomical thought
in the 16th century through to contemporary artistic exploration.
Covering
four themes (Objects, Marks, Impressions and Afterlives), 'Skin' takes
a philosophical approach. It begins by looking at the skin as a frontier
between the inside and the outside of the body. Early anatomists saw
it as having little value and sought to flay it to reveal the workings
of the body beneath.
The exhibition then moves to look at the skin as a living document:
with tattoos, scars, wrinkles or various pathologies, our skin tells
a story of our life so far. Finally, the skin is considered as a sensory
organ of touch and as a delicate threshold between life and death.
Included in the exhibition will be the psoriasis ceramic by Tamsin van
Essen.
For further information on the Skin exhibition, please visit the Wellcome
website www.wellcomecollection.org/whats-on/exhibitions/skin.aspx
The Wellcome is located at 183 Euston Road, London, NW1 2BE - with late
opening on Thursdays until 10pm.
 Patients speaking podcasts
To
complement the existing medical information podcasts, we are delighted
to launch 6 new patient experiences podcasts. You can listen at
www.psoriasis-association.org.uk/podcasts.html
Visit
us on Facebook! www.facebook.com/psoriasisassociation
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PsoKids CD-ROM
Lots of things can go wrong with the
skin that we can't help happening and psoriasis is just one of them.
An important thing is to remember that you're not alone. There are lots
of people all over the world who have psoriasis and deal with it every
single day! PsoKids is an interactive, fun packed CD-ROM designed mainly
for children (although there is a bit on their for parents/carers too!).
To order your free
copy, please
contact
us
Treatment / Company / Product
Information
NICE
issue final appraisal determination for etanercept, infliximab and adalimumab
for the treatment of psoriatic arthritis (review of previous technology
guidance)
In the final draft guidance (one step
before full guidance) NICE has recommended the use of etanercept (enbrel),
infliximab (remicade) and adalimumab (humira) for the treatment of adults
with active and progressive psoriatic arthritis when the following criteria
are met:
1. The person has peripheral arthritis
with three or more tender joints and three or more swollen joints, and
2. The psoriatic arthritis has not responded to adequate trials
of at least two standard disease-modifying antirheumatic drugs (DMARDs),
administered individually or in combination.
Treatment should normally be started
with the least expensive drug (taking into account administration costs,
required dose and product price per dose). This may need to be varied
for individual patients because of differences in the method of administration
and treatment schedules.
Etanercept, adalimumab or infliximab should be discontinued in people
whose psoriatic arthritis has not shown an adequate response at 12 weeks.
For further information, please visit www.nice.org.uk
Pinetarsol Solution and Pinetarsol Bath Oil
We have received notification from Crawford
Pharmaceuticals that due to a packing issue with the Pinetarsol Solution
200ml and 500ml and Pinetarsol Bath Oil 200ml and 500ml that has been
unable to be resolved, these products are now no longer going to available
in the UK marketplace. Crawford Pharmaceuticals said "it
is an issue which came about unexpectedly and, although we have looked
at various options to resolve the issue and bring the product back onto
the market place, no solution was viable in the end." Crawford
Pharmaceuticals advise that Pinetarsol is available direct from Australia
via the two websites below and recommend these two websites to members
of the public.
www.yourchemistshop.com.au
www.epharmacy.com.au
Dovonex
Ointment
LEO Pharmaceuticals are now manufacturing
Dovonex (Calcipotriol) Ointment again, to complement the existing Dovonex
Cream and Dovonex Scalp solution products they currently have available
on prescription only.
Betesil
Betamethasone Valerate has been a popular
potent topical steroid for a number of years. You may recognise it better
as the active ingredient in Betnovate, Bettamousse and Fucibet. It is
now available (on prescription only) as a plaster application for people
with very localised plaque psoriasis, in particular in difficult to
treat areas with topical treatments such as the elbows, knees and feet,
covering less than 5% of the body surface area. Each plaster measures
7.5cm x 10cm. To use Betesil, you clean and dry the area you are treating,
then cut the plaster to fit over the plaque of psoriasis (any plaster
left over can be put back into the protective sleeve and used at a later
date). The clear plaster is left in place for 24 hours. After removal
of the plaster the following day, allow 30 minutes before applying a
fresh treatment.
Betesil is not intended for use for longer than a 30 day period.
Please do not simply cover your existing steroid applications with a
plaster as this will increase the potency of the steroid and so the
likelihood of potential side effects. Betesil has been formulated in
order to give a regulated amount of Betamethasone Valerate under occlusion.
The
Psoriasis Association is pleased to inform you that Stelara (Ustekinumab)
has been approved by the National Institute for Health and Clinical
Evidence (NICE) for funding by the NHS (subject to conditions). For
further information please visit http://guidance.nice.org.uk/TA180
European Medicines Agency recommends suspension of the marketing authorisation
of Raptiva (Efalizumab)
The European Medicines Agency (EMEA) has recently
reviewed Efalizumab (Raptiva) following concerns regarding the long-term
safety for patients. The EMEA have recommended that the marketing authorisation
should be withdrawn across Europe. Patients currently using Raptiva
should make an appointment with their Dermatologist to discuss an alternative
treatment, but should not stop Rapitva abruptly.
Patients who have taken Raptiva in the past and have any questions or
concerns should make an appointment with their GP or Dermatologist.
For further information, please visit http://www.emea.europa.eu/humandocs/PDFs/EPAR/raptiva/RaptivaQ&A_1552509en.pdf
Xamiol Gel
Leo Pharma has recently launched a new
product to treat scalp psoriasis – Xamiol (pronounced zamiol)
gel. It contains the same active ingredients as Dovobet (calcipotriol
– the vitamin D component and betamethasone – the steroid
component).
To use Xamiol, part your hair into sections, and then apply the gel
with your fingers to the areas of psoriasis on your scalp. Rub the gel
in with your fingertips. For best results Leo Pharma recommend you leave
the gel on overnight, and then wash it out the next morning. In order
to wash Xamiol gel out of the hair, apply a mild shampoo to dry hair,
especially to the areas that the gel was applied, leave the shampoo
on for a couple of minutes and then wash your hair as usual. You may
need to wash your hair twice.
Xamiol gel is available on prescription only.
NICE issue Guidelines regarding the use of Adalimumab (Humira) for severe
psoriasis
The
National Institute for Health and Clinical Excellence (NICE) have issued
their guidelines regarding the use of Adalimumab
to treat psoriasis. NICE have recommended Adalimumab be prescribed when
"the condition is severe" - defined by a
PASI score greater than 10 and a DLQI score greater than 10, and "their
condition has not improved with other treatments such as ciclosporin,
methotrexate and PUVA (psoralen and long-wave ultraviolet radiation),
or they have had side effects with these in the past or there is a medical
reason why they should not be given these treatments."
To read the guidelines, please follow
the link to the NICE
website. For further information on Adalimumab, please click here
NICE issue Guidelines regarding the use of Infliximab (Remicade) for
severe psoriasis
The National Institute for Health and
Clinical Excellence (NICE) have issued their guidelines regarding the
use of Infliximab to treat psoriasis. NICE have recommended Infliximab
be prescribed when "the disease is very severe as defined by a
total Psoriasis Area Severity Index (PASI) of 20 or more and a Dermatology
Life Quality Index (DLQI) of more than 18"
and "the psoriasis has failed to respond to standard
systemic therapies such as ciclosporin, methotrexate or PUVA, or the
person is intolerant to or has a contraindication to these treatments".
To read the guidelines, please follow the link to the NICE
website. For
further information on Infliximab, please click here
Adalimumab (Humira) receives its license for use to treat moderate to
severe psoriasis
Adalimumab is the first fully human
anti-TNF (tumour necrosis factor) monoclonal antibody approved for the
treatment of plaque psoriasis. “The licensing of adalimumab offers
a valuable new treatment option for people living with moderate-to-severe
psoriasis, a very difficult and often isolating condition,” said
Gladys Edwards from the Psoriasis Association. ”We welcome the
approval of new therapies such as adalimumab that can significantly
improve the quality of life of patients and expand the options available
to those who are most in need of treatment.”
Adalimumab is a subcutaneous injection, meaning it can
be self-administered at home after suitable training.
For further information regarding Adalimumab
please click here
Etrivex Shampoo
Galderma (UK) has recently launched a
new product for the treatment of moderate scalp psoriasis in adults.
Etrivex is a short contact corticosteroid shampoo that is only available
on prescription. It is stocked by all wholesalers and most pharmacies.
It is important to follow the instructions carefully as the method of
application is different to that of conventional treatments - approximately
half a tablespoon (7.5ml) should be applied directly to your dry scalp
and massaged into the lesions. Etrivex should be left in place for 15
minutes. Then, add water and lather, avoiding contact with the eyes
and other delicate areas - rinse thoroughly, condition and style as
normal.
Availability of Psorin Ointment and Scalp Gel
LPC Pharmaceuticals have informed the
Psoriasis Association that Psorin Scalp Gel is available, but Psorin
Ointment is being reviewed by the MHRA - no indication has been given
as to when this will become available again.
Patient Information Leaflets (PIL's)
Do you discard the packaging your medications
come in only to find a couple of weeks later that you could do with
knowing a little more about your treatment? Well help is at hand!
ALL PIL's can now be accessed
online at http://emc.medicines.org.uk/
Psoriasis
Support Groups
| London
Group |
Dermatology
Department, Whittington Hospital, Highgate Hill
Thursday Sept 2nd- 2pm-4pm
Thursday Dec 16th- 2pm-4pm |
| Reading
Group |
Wednesday
27th January, 7-9pm at the Royal Berkshire Hospital. Park in the
Redlands road carpark and go to Outpatients 2 (parking permits will
be provided on the night) |
| Salford
Support Group |
Second
Wednesday of every month in Community Room 2, Pendleton Gateway
Centre, Lime Court, Salford, at 2pm |
| Salisbury
Psoriasis Support Group |
Take
place in the Railway Tavern, Mill Road, Salisbury and commence at
7.00pm
Wednesday 12th May 2010 - talk from a nutritionist
Wednesday 14th July 2010 - BBQ |
| Treliske
(Cornwall) Support Group |
Meet
in the Dermatology Unit, Treliske Hospital at 6.30 - 8.00pm
Wednesday 4th August 2010
Wednesday 3rd November 2010
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To visit
our news archive click here.
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