NICE Recommends Nemolizumab for Moderate to Severe Atopic Dermatitis
NICE has issued final guidance recommending nemolizumab (Nemluvio) as a treatment option for people aged 12 and above with moderate to severe atopic dermatitis, where previous systemic immunosuppressants have proved ineffective or are unsuitable. Treatment should be evaluated after 16 weeks to ensure clinical response.
Introduction
The NICE technology appraisal committee has approved nemolizumab in combination with topical corticosteroids or calcineurin inhibitors for use in individuals aged 12 years and over with moderate to severe atopic dermatitis. The guidance specifies this use is appropriate when systemic treatments have not been effective or are not suitable, and a biologic agent would otherwise be offered. NHS funding must be in place within 90 days of publication.
Clinical Evaluation Criteria
The committee recommends assessing response by week 16. Treatment should be discontinued if there is not at least a 50 percent reduction in the Eczema Area and Severity Index score (EASI 50) and a four-point improvement in Dermatology Life Quality Index (DLQI). These strict criteria support targeted and effective use of nemolizumab.
Clinicians are encouraged to consider skin tone in interpreting EASI scores, and to adjust DLQI assessments for individuals with communication difficulties or disabilities.
Evidence and Clinical Rationale
Clinical trials (ARCADIA 1, ARCADIA 2 and ARCADIA‑CYCLO) showed that nemolizumab significantly improves symptoms compared with placebo, supporting its use in people who have insufficient response to existing therapies. The committee concluded that nemolizumab is cost effective compared with other biological medicines, although not compared with Janus kinase inhibitors. The drug has been positioned after at least one systemic immunosuppressant has been tried, aligning with professional and patient expectations.
Implementation and Access
NHS England and integrated care boards must ensure treatment availability within 90 days of guidance publication. A commercial patient access scheme ensures discounted pricing through the NHS for eligible patients. Existing treatment courses can continue unaffected pending review with the prescribing clinician.
Practical Considerations
Nemolizumab is administered alongside topical therapies when systemic treatment is appropriate. Patients should be monitored regularly, with strict adherence to stop criteria at 16 weeks. Clinicians should document response outcomes, consider skin tone and communication factors in assessment and report adverse events in line with Yellow Card procedures.
Next Steps for Secondary Care
• Identify patients aged 12 and over with moderate to severe atopic dermatitis who meet eligibility criteria.
• Confirm existing systemic treatment failures before initiating biologic therapy.
• Set up monitoring pathways and schedule 16‑week reviews.
• Apply to NHS funding via the patient access scheme promptly.
• Contribute clinical and safety data to support ongoing evaluation and compliance.
Citation:
National Institute for Health and Care Excellence. (2025, 2 July). Nemolizumab for treating moderate to severe atopic dermatitis in people 12 years and over (TA1077). Retrieved from https://www.nice.org.uk/guidance/ta1077
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