- Prescribing Advice for GPs - https://www.prescriber.org.uk -

SMC Update - April 2020

The Scottish Medicines Consortium (SMC) has issued its monthly advice on newly licensed medicines.

Fampridine (Fampyra®) has been accepted, following a resubmission, for use to aid the improvement of walking in adult patients with multiple sclerosis with walking disability (EDSS 4-7). It should be noted that this advice applies only in the context of an approved NHSScotland Patient Access Scheme (PAS) arrangement and is therefore expected to be supplied via hospitals. It is also noted that the current NICE Guidance recommends against using this medication in England "because it is not a cost effective treatment".

Insulin glargine / Lixisenatide (Suliqua®) has been accepted for restricted use, in combination with metformin, for the treatment of adults with type 2 diabetes mellitus, to improve glycaemic control when this has not been provided by metformin alone or metformin combined with another oral glucose-lowering medicinal product or with basal insulin. The restriction limits use to patients who are uncontrolled on basal insulin (glycosylated haemoglobin [HbA1c] > 7.5% [59mmol/mol]) and for whom a GLP-1 receptor agonist is appropriate as an add-on intensification therapy to basal insulin analogues.

Naldemedine (Rizmoic®) has been accepted for use in the treatment of opioid-induced constipation (OIC) in adult patients who have previously been treated with a laxative. It is noted that compared to placebo this medication significantly improved the spontaneous bowel movement response rate in patients with opioid-induced constipation and either non-cancer or cancer pain.

Action: Clinicians should be aware of the recommendations of the SMC. Routine use of rejected and restricted medicines should be avoided.