The Scottish Medicines Consortium (SMC) has accepted etanercept (Enbrel™) for restricted use within NHS Scotland for the treatment of chronic severe plaque psoriasis in children and adolescents from the age of 8 years who are inadequately controlled by, or are intolerant to, other systemic therapies or phototherapies.

It should be used only when the following criteria are met:

• The disease is severe as defined by a total Psoriasis Area Severity Index (PASI) of 10 or more and a Dermatology Life Quality Index (DLQI) of more than 10;
• The psoriasis has failed to respond to standard systemic therapies including ciclosporin,
methotrexate and PUVA (psoralen and long-wave ultraviolet radiation); or the person is intolerant to, or has a contraindication to, these treatments;
• Etanercept treatment should be discontinued in patients whose psoriasis has not responded adequately at 12 weeks.