NICE has published its final guidance (Technology Appraisal 220) on the use of golimumab for the treatment of psoriatic arthritis within the NHS.

Golimumab (Simponi®) is a human monoclonal antibody that prevents the binding of tumour necrosis factor (TNF) to its receptors.  It is licensed in the UK for the treatment of active and progressive psoriatic arthritis (alone or in combination with methotrexate) in adults when the response to previous disease-modifying antirheumatic drug (DMARD) therapy has been inadequate.

In its guidance, NICE recommends golimumab as an option for the treatment of active and progressive psoriatic arthritis in adults only if the following apply:

• it is used as described for other TNF inhibitor treatments in ‘Etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis’ (NICE technology appraisal guidance 199), and

• the manufacturer provides the 100mg dose of golimumab at the same cost as the 50mg dose

When using the Psoriatic Arthritis Response Criteria (PsARC; as set out in NICE technology appraisal guidance 199), healthcare professionals should take into account any physical, sensory or learning disabilities, or communication difficulties that could affect a person’s responses to components of the PsARC and make any adjustments they consider appropriate.

The full guidance, available at the link below, notes that the key drivers for these recommendations were as follows:

• the evidence was not robust enough to confirm clinically important differences in the effectiveness of golimumab compared with the other TNF inhibitors recommended in NICE technology appraisal guidance 199

• although golimumab was not as cost effective as etanercept, the cost-effectiveness estimates of the 50mg dose of golimumab compared with adalimumab and infliximab were acceptable