The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of October 2022. This month there is one guideline and one technology appraisal that impact upon primary care.
The Osteoarthritis in over 16s: diagnosis and management guideline has been published. It covers the diagnosis, assessment and non-surgical management of osteoarthritis. It aims to improve management of osteoarthritis and the quality of life for people with osteoarthritis.
The SQ HDM SLIT for treating allergic rhinitis and allergic asthma caused by house dust mites technology appraisal has been terminated. NICE is unable to make a recommendation on this treatment because the manufacturer did not provide an evidence submission. The SPC notes that treatment should only be initiated by physicians with experience in treatment of allergic diseases.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.
The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for October 2022 (PDF).
This issue advises clinicians that the seventh annual #MedSafetyWeek social media campaign will take place from the 7th to the 13th November 2022. This year the focus is on the importance of reporting suspected adverse reactions to medicines and vaccines. Reports for medical devices or other healthcare products are also encouraged. Healthcare professionals are asked to support the campaign and talk to their patients and colleagues about side effects and how they can report suspected problems to the Yellow Card scheme.
This issue contains the latest COVID-19 vaccine and medicine information including updated shelf life and storage instructions for Spikevax®.
Lastly in this issue is a summary of letters to healthcare professionals in September. These generally related to supply issues and recalls.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.
Two Medicines Supply Notifications have been disseminated this week warning of supply chain shortages for two GLP-1 reception agonists, namely dulaglutide (Trulicity®) and semaglutide (Ozempic®).
The notification for dulaglutide advises that all strengths of this product will have limited supplies until at least January 2023. It is noted that current supplies should be able to maintain existing patient but it is recommended that no new patients are commenced on this treatment at this time. Further information is available from the Specialist Pharmacy Service for dulaglutide (registration required).
The notification for semaglutide advises that the 1mg strength is out of stock currently until mid-October. Thereafter, it will remain in limited supplies until at least January 2023. Using lower strengths will only partially support demand and it is again recommended that no new patients are commenced on this treatment at this time. Further information is available from the Specialist Pharmacy Service for semaglutide (registration required).
It should be noted that exentide and liraglutide are currently unaffected by this issue, however the change in drug choice may have impacts on the frequency or method of administration and therefore if switching is being considered it should be undertaken with patient involvement. It should also be considered that wholesale changes may unnecessarily stress other drug formulations in the supply chain.
Action: Clinicians should be aware of the supply shortages of dulaglutide and semaglutide. As recommended, no new patients should be commenced on these therapies at this time. If treatment intensification is necessary to manage blood glucose levels alternative treatments may need to be considered and used.
During September 2022 Clinical Knowledge Summaries were published or updated in the following areas.
All of the topics have been reviewed and updated with minor structural and layout changes. The The Contraception - progestogen-only methods topic is new. topic has been updated to include information on starting and swapping to drosperinone. The Depression topic has been updated in line with NICE guidance. These changes included updated definitions of depression severity and amended options for treatment. The Psoriasis topic has also been updated with the recommendations on diagnosis and management of psoriasis amended in line with current evidence.
Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.
