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.
The clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events technology appraisal is a review (PDF). There has been a change in the advice as follows:
- 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.