The National Institute for Health and Clinical Excellence (NICE) has published an “appraisal consultation document” on the use of etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis. The appraisal Committee’s preliminary recommendations are (taken directly from source):

1. Etanercept 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.
• 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.

2. Infliximab is recommended for the treatment of adults with active and progressive psoriatic arthritis only if:
• the criteria above are met and
• the person is intolerant of, or has contraindications to, etanercept and adalimumab, or subcutaneous administration is unsuitable for them.

3. Etanercept, adalimumab or infliximab treatment should be stopped in people whose psoriatic arthritis has not shown an adequate response using the Psoriatic Arthritis Response Criteria (PsARC) at 12 weeks. An adequate response is defined as an improvement in at least two of the four PsARC, (one of which has to be joint tenderness or swelling score) with no worsening in any of the four criteria.

The consultation period is from 15 March to 8 April 2010, and the second appraisal committee meeting has been scheduled for 20 April 2010.