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10 June 2022

Skyrizi (Risankizumab) - NICE approves new treatment for psoriatic arthritis

The injectable treatment gets approval for psoriatic arthritis in England and Wales.

    The National Institute for Health and Care Excellence (NICE) has today published its decision to recommend the biologic medicine, Skyrizi (also known by its generic name, Risankizumab), as a treatment option for adults with active psoriatic arthritis in England and Wales. This brings England and Wales in line with Scotland where the Scottish Medicines Consortium (SMC) approved Skyrizi for the treatment of psoriatic arthritis in April 2022.

    The NICE guidance states that Skyrizi, alone or with methotrexate, is recommended as an option for treating active psoriatic arthritis in adults whose condition has not responded well enough to disease-modifying antirheumatic drugs (DMARDs) or who cannot tolerate these treatments, if the individual has:

    • Peripheral arthritis with 3 or more tender joints and 3 or more swollen joints
    • Moderate to severe psoriasis (a body surface area of at least 3% affected by plaque psoriasis and a Psoriasis Area and Severity Index [PASI] score greater than 10)
    • Already had 2 conventional DMARDs and at least 1 biological DMARD

    • How does Skyrizi work?

      Skyrizi blocks the activity of interleukin-23 (IL-23), a chemical ‘messenger’ in the immune system which signals other cells to cause inflammation. In people with psoriasis and/or psoriatic arthritis, the immune system is overactive and creates too much inflammation, which leads to the development of psoriasis and/or psoriatic arthritis symptoms. Skyrizi 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 and psoriatic arthritis for some people who take it.

      How is Skyrizi used?

      Skyrizi is taken as an injection under the skin via a pre-filled syringe or pre-filled injection pen. The recommended dose is 150mg. When Skyrizi was launched you needed to have two injections of 75mg at each dose. However, as of 9th July 2021 each injection now contains the full dose (150mg) and so only one injection is required each time. The injections should be administered in areas such as the thighs or abdomen avoiding where the skin is tender, bruised or affected by psoriasis.

      When you begin taking Skyrizi you will have your first injection(s), followed four weeks later by your next. After that Skyrizi is usually taken every 12 weeks. Most people will be trained by a nurse to give the injection to themselves.

      People taking Skyrizi are likely to need regular blood tests – usually carried out by a Rheumatology specialist, or by their own GP, to monitor general health whilst on the treatment.

      People taking Skyrizi are more at risk of infections and so should be vaccinated against pneumonia and have an annual flu vaccination. However, not all vaccinations are safe in people taking Skyrizi and ‘live’ vaccinations (for example yellow fever, shingles) should not be given whilst on Skyrizi and for one year after stopping Skyrizi. Check with a doctor, nurse or pharmacist before having any vaccinations or taking other medication if you are not sure.

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