Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

NICE Guidance - May 2020

The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of May 2020. This month there are four rapid guideline and evidence reviews and two evidence summaries related to COVID-19 that impact upon primary care.

The COVID-19 rapid guideline: rheumatological autoimmune, inflammatory and metabolic bone disorders guideline has been updated. The update highlights factors to take into account when considering temporarily stopping some drugs for children and young people.

The COVID-19 rapid guideline: children and young people who are immunocompromised guideline has been published and updated. It aims to maximise the safety of children and young people who are immunocompromised during the COVID-19 pandemic. It also aims to protect staff from infection and enable services to make the best use of NHS resources. The update highlighted that immunosuppressant medicines should be reviewed if a patient may have COVID-19 or there are other medical concerns.

The COVID-19 rapid guideline: chronic kidney disease guideline has been published. It to maximise the safety of adults with chronic kidney disease during the COVID-19 pandemic. It also aims to protect staff from infection and enable services to make the best use of NHS resources.

The COVID-19 rapid guideline: interstitial lung disease guideline has been published. It aims to maximise the safety of adults with interstitial lung disease, including idiopathic pulmonary fibrosis and pulmonary sarcoidosis, during the COVID-19 pandemic. It also aims to protect staff from infection and enable services to make the best use of NHS resources.

The COVID-19 rapid evidence summary: angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in people with or at risk of COVID-19 evidence summary has been published. It aims to determine whether up regulation of angiotensin-converting enzyme 2, potentially as a result of taking ACEIs or ARBs, is associated with an increased risk of developing COVID-19 or developing more severe symptoms. This analysis found two observational studies that were of poor quality and subject to bias and confounding. As such conclusions cannot be drawn without further research.

The COVID-19 rapid evidence summary: Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) for people with or at risk of COVID-19 evidence summary has been published. It aims to determine if long term use of NSAIDs is associated with an increased risk of developing COVID-19 or developing more severe symptoms. A literature search identified no evidence from published scientific studies. However, it is noted that NSAIDs and COVID-19 can both contribute to respiratory, cardiovascular and renal complications.

Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.

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