The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of January 2025. This month there are two guidelines and one technology evaluation that impact upon primary care.
The Maternal and child nutrition: nutrition and weight management in pregnancy, and nutrition in children up to 5 years guideline has been published. It covers nutrition and weight management in pregnancy for anyone who may become pregnant, is planning to become pregnant or is already pregnant, and nutrition in children up to 5 years. Care of babies and children born preterm or with low birth weight is not covered. The guideline does not give detailed advice on what constitutes a healthy diet.
The Digitally enabled therapies for adults with depression: early value assessment health technology assessment has been updated. Deprexis has been removed from recommendations because it is no longer available in the UK. Beating the Blues was removed in February 2024 because it is no longer available since the supplier ceased trading.
The Overweight and obesity management guideline has been published. It covers the prevention and management of overweight, obesity and central adiposity in children, young people and adults. It brings together and updates all NICE's previous guidelines on overweight and obesity. It does not cover pregnancy.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.
The Scottish Medicines Consortium (SMC) has issued its monthly advice on newly licensed medicines.
Ciclosporin (Cequa®) drops have been accepted for restricted use in the treatment of moderate-to-severe Dry Eye Disease (keratoconjunctivitis sicca) in adult patients who have not responded adequately to artificial tears. The restriction limits use to cases of severe keratitis in adult patients.
Relugolix, estradiol, norethisterone tablets (Ryeqo®) has been accepted for use in adult women of reproductive age for symptomatic treatment of endometriosis in women with a history of previous medical or surgical treatment for their endometriosis.
Action: Clinicians should be aware of the recommendations of the SMC. Routine use of rejected and restricted medicines should be avoided.
The manufacturer of Seroxat® has written to healthcare professionals in December 2024 and advised that this product will be discontinued in 2025.
Seroxat® suspension was discontinued in October 2022. The tablets have been discontinued for commercial reasons, there are no safety concerns. The three strengths will all be discontinued; the 20mg in March 2025, the 30mg in May 2025 and the 10mg in November 2025. The phased discontinuation is likely due to existing stock in the supply chain.
There are currently several generic suppliers of the tablets and this discontinuation is expected to only affect patients issued branded prescriptions.
Action: Clinicians should be aware of this product being discontinued. It would be prudent to run clinical system searches to identify any patients who are currently prescribed this product to assess if a suitable alternative can be arranged.
The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of December 2024. This month there are four guidelines that impact upon primary care.
The Urinary tract infection (recurrent): antimicrobial prescribing guideline has been updated. It sets out sets out an antimicrobial prescribing strategy for preventing recurrent urinary tract infections in children, young people and adults who do not have a catheter. This update makes new recommendations on methenamine hippurate as a preventative treatment and amends existing recommendations on referral and seeking specialist advice, oestrogen for prevention, and choice of antibiotic or antiseptic prophylaxis.
The Tirzepatide for managing overweight and obesity technology appraisal has been published. Tirzepatide is recommended as an option for managing overweight and obesity, alongside a reduced-calorie diet and increased physical activity in adults, only if they have:
- an initial body mass index (BMI) of at least 35 kg/m2 and
- at least 1 weight-related comorbidity.
It is recommended to use a lower BMI threshold (usually reduced by 2.5 kg/m2) for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds. If less than 5% of the initial weight has been lost after 6 months on the highest tolerated dose, a decision should be made on whether to continue treatment, taking into account the benefits and risks of treatment for the person.
It should be noted that the usual 90 period for implementation has been extended to 180 days with a further 3 year period to increase eligibility in stages based on health need and clinical benefit. It is also predicted that is could take up to 9 years to create a mature treatment pathway for obesity in primary care.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.
The Scottish Medicines Consortium (SMC) has issued its monthly advice on newly licensed medicines.
Vibegron (Obgemsa®) has been accepted for use in the symptomatic treatment of adult patients with overactive bladder (OAB) syndrome. It is noted that this treatment offers an additional choice in the therapeutic class of beta-3 adrenergic receptor agonists.
Levodopa / carbidopa / entacapone intestinal gel (Lecigon®) has been rejected for the treatment of advanced Parkinson's disease with severe motor fluctuations and hyperkinesia or dyskinesia when available oral combinations of Parkinson medicinal products have not given satisfactory results. The submitting company did not present a sufficiently robust clinical or economic analysis to gain acceptance by SMC.
Action: Clinicians should be aware of the recommendations of the SMC. Routine use of rejected and restricted medicines should be avoided.
