The National Institute of Health and Clinical Excellence (NICE) has published new guidance for the month of February 2012. This month there is one technology appraisal that impact upon primary care.

Exenatide prolonged release (Bydureon^®) has been reviewed in a technology appraisal and is approved for use in combination with oral therapies when glycaemic control is inadequate (HbA1c > 7.5% or 59mmol/mol) and:

• BMI ≥ 35kg/m² and psychological or medical problems associated with high body weight
• BMI < 35kg/m² and insulin therapy would have significant occupational implications or weight loss would benefit obesity-related comorbidities

It is also advised the treatment is reviewed at 6 months and discontinued if:

• there has not been a reduction in HbA1c of 1% or 11mmol/mol if used in dual therapy
• there has not been a reduction in HbA1c of 1% or 11mmol/mol and a weight loss of at least 3% of initial body weight

Action: Clinicians should be aware of this new guidance and implement any necessary changes to practice.