etanercept (Enbrel)

following an abbreviated submission

etanercept (Enbrel®) is accepted for restricted use within NHS Scotland.

Indication under review: for the treatment of chronic severe plaque psoriasis in children and adolescents from the age of 6 years who are inadequately controlled by, or are intolerant to, other systemic therapies or phototherapies.

SMC restriction:
- 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.

Etanercept has previously been accepted for use in this indication in adults in NHS Scotland as NHS Health Improvement Scotland advised that NICE Multiple Technology Appraisal No 103 is valid for Scotland. Etanercept has previously been accepted for restricted use by SMC in adolescents and children from the age of 8 years.

Etanercept is also listed in the British National Formulary for Children 2011-2012 as one of a number of drugs affecting the immune response available for treatment of severe refractory psoriasis.