NICE had rejected the NHS use of apremilast (Otezla) alone or in combination for the treatment of active psoriatic arthritis when DMARDs are unsuitable.
NICE concluded that apremilast is clinically effective compared with no other treatment. However, when compared with TNF-alpha inhibitors, apremilast was the least clinically effective for treating psoriatic arthritis. Although some costs were saved by the use of apremilast, NICE concluded they were not sufficient to justify the health losses.
NICE technology appraisal TA372
Professor Carole Longson, Director of the Health Technology Evaluation Centre at NICE, explained "there was not enough robust evidence demonstrating that apremilast slows progression of the disease compared to TNF-alpha inhibitors."
This follows a previous rejection by NICE, for the use of apremilast in moderate to severe plaque psoriasis.