Adults with severe plaque psoriasis who do not respond to first-line treatments should be offered biological therapies, according to a NICE technology appraisal issued last week. NICE recommends the TNF-alpha blocker etanercept (Enbrel) for the treatment of psoriasis that has not responded to ciclosporin, methotrexate or ultraviolet radiation therapy. If there is no response after 12 weeks, etanercept treatment should be discontinued and treatment with the selective t-cell modulator efalizumab (Raptiva) should be considered.
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