Shared-care Guidelines
Click here for a downloadable word document of the shared care agreement forms:
DMARDs Shared Care Agreement (Version 1.1)
Generic Shared Care Agreement Form
This guidance does not replace the SPC’s, which should be read in conjunction with this guidance.
This guidance does not replace the SPC’s, which should be read in conjunction with this guidance.
Denosumab 120mg injection - Prevention of skeletal-related events (pathological fracture, radiation to bone, spinal cord compression or surgery to bone) in adults with advanced malignancies involving bone.
Treatment of adults and skeletally mature adolescents with giant cell tumour of bone that is unresectable or where surgical resection is likely to result in severe morbidity.
Denosumab 60mg injection - Treatment of osteoporosis in postmenopausal women and in men at increased risk of fracture and treatment of bone loss
associated with long-term systemic glucocorticoid therapy in adult patients at increased risk of fracture
Treatment of active rheumatoid arthritis and active psoriatic arthritis.
Rheumatoid arthritis, severe psoriasis, severe active juvenile idiopathic
arthritis, severe psoriatic arthritis, mild to moderate Crohn’s disease
Unlicensed: Severe Eczema, Lichen Planus, Felty’s syndrome, severe Crohn’s disease
N.B. Not all brands/formulations are licensed for all indications – please refer to individual SPCs
This protocol only applies to the unlicensed indications listed below. Transplant protocols should be followed for licensed indications.
Unlicensed: Severe rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, connective tissue diseases with severe / organ-threatening manifestations, interstitial lung disease (not to be used in idiopathic pulmonary fibrosis IPF), vasculitidies, as maintenance post cyclophosphamide in patients for whom azathioprine is contra-indicated or is inappropriate.
Licensed: Severe active rheumatoid arthritis, including juvenile forms, Wilson's disease (hepatolenticular degeneration) in adults and children (0 to 18 years).
Licensed: Rheumatoid arthritis; ulcerative colitis, Crohn’s disease in adults and children
Unlicensed: Sero-negative spondyloarthropathy including psoriatic arthritis and psoriasis.