The National Institute of Health and Clinical Excellence (NICE) has published new guidance for the month of January 2012. This month there is one clinical guideline and two technology appraisals that impact upon primary care.
The updated Epilepsy clinical guideline now includes several newer anti-epileptic drugs that have been introduced since the original guideline. New recommendations include:
- Basing therapeutic choice on the presenting epilepsy syndrome or presenting seizure type(s) where the syndrome type is unclear.
- Advising women and girls of the possible risk of malformation and neuro-developmental impairment in an unborn child when sodium valproate is used.
- Only prescribe buccal midazolam or rectal diazepam for use in the community for individuals who have had a previous episode of prolonged or serial convulsive seizures.
Roflumilast has been reviewed in a technology appraisal for the management of severe chronic obstructive pulmonary disease. The drug is only recommended as part of a research study (clinical trial) that is investigating using roflumilast at the same time as a bronchodilator.
Apixaban has also been reviewed in a technology appraisal for the prevention of venous thromboembolism after total hip or knee replacement in adults. The treatment has been recommended as an option based on greater efficacy and lower acquisition costs than some alternatives. Primary care may be asked to issue treatment completions.
Action: Clinicians should be aware of this new guidance and implement any necessary changes to practice.
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