NICE approves alemtuzumab for multiple sclerosis

Genzyme's immunosuppressant alemtuzumab (Lemtrada) has been given the green light for use on the NHS in adults with active relapsing-remitting multiple sclerosis.

Alemtuzumab (Lemtrada) binds to the CD52 surface antigen of certain T-cells, causing both antibody-dependent and complement-mediated cell lysis | SCIENCE PHOTO LIBRARY
Alemtuzumab (Lemtrada) binds to the CD52 surface antigen of certain T-cells, causing both antibody-dependent and complement-mediated cell lysis | SCIENCE PHOTO LIBRARY

Unlike existing treatments that require administration daily or several times a week, Lemtrada is given as a short course of intravenous infusions (one daily for five days) followed 12 months later by a second short course (one daily for three days). It must be administered under specialist supervision and suitable equipment must be at hand to enable timely diagnosis and management of serious adverse reactions to the drug.

Alemtuzumab was previously available as MabCampath for the treatment of certain leukaemias and lymphomas but was withdrawn in 2012.

NICE guidance on alemtuzumab for treating relapsing-remitting multiple sclerosis (TA312)

Stelara rejected for psoriatic arthritis

NICE also assessed the clinical and cost-effectiveness of ustekinumab (Stelara) for psoriatic arthritis but did not approve the interleukin inhibitor for use on the NHS. The institute accepted that ustekinumab is clinically effective compared with conventional DMARD treatments; however, ustekinumab was less effective than tumour necrosis factor (TNF) inhibitors and NICE's economic analysis indicated that it was not a cost-effective option.

Following an earlier NICE appraisal, ustekinumab may still be prescribed on the NHS for severe plaque psoriasis when standard systemic therapies are inadequate or not tolerated.

NICE guidance on ustekinumab for treating active psoriatic arthritis (TA313)

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