Ustekinumab for the treatment of adults with moderate to severe psoriasis
Le comité anglais NICE a publié un guide pour le traitement du psoriasis par l’ustekinumab.
Ce traitement est indiqué en cas de psoriasis en plaque :
- Si le psoriasis est sévère et affecte la qualité de vie
- Si le psoriasis n’a pas bien répondu à d’autres traitements comme la ciclosporine, le methotrexate ou la PUVA thérapie, ou si les effets secondaires ont obligé à l’arrêt de ces traitements, ou si ces traitements sont contre-indiqués.

NICE a obtenu du Laboratoire de conserver le même coût de traitement pour les patients de plus de 100 kg que pour les autres.
Le traitement doit être interrompu en cas d’échec observé après 16 semaines de traitement.

Ustekinumab is recommended as a possible treatment for people with plaque psoriasis if:
standard assessments show that their psoriasis is severe and is affecting their quality of life and heir psoriasis has not improved with other treatments such as ciclosporin, methotrexate or PUVA (psoralen and long-wave ultraviolet radiation), or they have had side effects with these treatments in the past or there is a medical reason why they should not be given them.

The manufacturer of ustekinumab has agreed to a ‘patient access scheme’ which means that they provide the higher dose needed for people who weigh more than 100 kg at the same total cost as the lower dose for people who weigh 100 kg or less.
Ustekinumab treatment should be stopped if standard assessments show that a person’s psoriasis has not clearly improved after 16 weeks.
When assessing how a person’s psoriasis affects their quality of life, healthcare professionals should take into account any disabilities or difficulties in communicating which might mean that the standard assessments do not provide accurate information.

Guidance documents
· Guidance PDF format | MS Word format
· Quick reference guide PDF format
· Understanding NICE guidance PDF format | MS Word format
· TA180 Ustekinumab ar gyfer trin oedolion â soriasis cymedrol i ddifrifol: deall canllawiau NICE

http://www.nice.org.uk/TA180