The National Institute of Health and Clinical Excellence has published new guidance for the month of December 2010. This month there are two technology appraisals that impact upon primary care.
- Treatment with modified-release dipyridamole in combination with aspirin for people who have had an ischaemic stroke is now recommended only if clopidogrel is contraindicated or not tolerated
- Treatment with modified-release dipyridamole in combination with aspirin for people who have had an ischaemic stroke or a transient ischaemic attack is no longer limited to 2 years’ duration from the most recent event
- Clopidogrel is no longer recommended only for people who are intolerant of aspirin and have had an occlusive vascular event or have peripheral arterial disease
There is also a new appraisal for prucalopride (Resolor®) for the treatment of chronic constipation in women (PDF). Treatment is recommended provided at least two different types of laxatives at the highest possible recommended doses, for at least 6 months, which has provided inadequate relief and invasive treatment for constipation is being considered. In this instance a 4 week trial can be offered with a subsequent review of benefit. It is also recommended that prescribing is undertaken by a clinician with experience of treating chronic constipation.
Action: Clinicians should be aware of these recommendations and implement any necessary changes to practice.