Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

MTRAC Reviews - June 2013

MTRAC issued three new Commissioning Support reviews in June 2013. The reviews cover linaclotide, ingenol mebutate and imiquimod.

The Linaclotide (Constella®) summary advises that this drug is suitable for prescribing in primary care but only when all other treatment alternatives have proved ineffective or are contraindicated. The committee considered the drug to have a lower place in therapy and relatively weak evidence as there are no comparative studies with existing treatments.

The Ingenol mebutate (Picato®) summary advises that this drug is suitable for prescribing in primary care where there is a confident diagnosis of actinic ketatosis. The committee considered the evidence to be relatively strong but suggest a lower place in therapy based on limited clinical experience and the availability of other, more established treatments.

The Imiquimod (Zyclara®) summary advises that this drug is suitable for prescribing in primary care where there is a confident diagnosis of actinic ketatosis. The committee considered the evidence to be relatively strong but suggest a lower place in therapy based on a higher acquisition cost in comparison to other treatments including imiquimod
5% cream. As such this 3.75% cream offers little advantage over the existing 5% cream.

Action: Clinicians should be aware of these reviews and use the recommendations to guide appropriate use of these medicines in current practice.

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