The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of December 2023. This month there are three guidelines, two technology evaluations and two technology appraisals that impact upon primary care.
The Acne vulgaris: management guideline has been updated. It covers management of acne vulgaris in primary and specialist care. The update clarifies recommendations on oral isotretinoin treatment in line with the 2023 MHRA advice on the introduction of new safety measures.
The Digitally enabled therapies for adults with depression health technology assessment has been updated. Three digitally enabled therapies can be used as treatment options for adults with depression while further evidence is generated on their clinical and cost effectiveness. This update provide further information in the evidence generation plan.
The Digitally enabled therapies for adults with anxiety disorders health technology assessment has been updated. Six digitally enabled therapies can be used as treatment options for adults with anxiety disorders while further evidence is generated on their clinical and cost effectiveness. This update provide further information in the evidence generation plan.
The Cardiovascular disease: risk assessment and reduction, including lipid modification guideline has been published. It covers identifying and assessing risk of cardiovascular disease (CVD) in adults without established CVD and lifestyle changes and lipid-lowering treatment for primary and secondary prevention of CVD. It replaces previous guidance and contains a new recommendation on the target lipid level for secondary prevention of CVD.
The Empagliflozin for treating chronic kidney disease technology appraisal has been published. This treatment is recommended as an option for treating chronic kidney disease (CKD) in adults, only if:
- it is an add-on to optimised standard care including the highest tolerated licensed dose of angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs), unless these are contraindicated, and
- people have an estimated glomerular filtration rate of:
- 20 ml/min/1.73 m2 to less than 45 ml/min/1.73 m2 or
- 45 ml/min/1.73 m2 to 90 ml/min/1.73 m2 and either:
- a urine albumin-to-creatinine ratio of 22.6 mg/mmol or more, or
- type 2 diabetes.
The Targeted-release budesonide for treating primary IgA nephropathy technology appraisal has been published. This treatment is recommended as an option for treating primary immunoglobulin A nephropathy. This recommendation is contingent on a commercial agreement and as such it is expected prescribing would remain with a specialist.
The Bipolar disorder: assessment and management guideline has been updated. It covers recognising, assessing and treating bipolar disorder (formerly known as manic depression) in children, young people and adults. This update amends recommendations in line with the latest MHRA guidance on the use of valproate.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.