The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of January 2024. This month there are three guidelines that impact upon primary care.
The COVID-19 rapid guideline: managing COVID-19 guideline has been updated. It covers managing COVID-19 in babies, children, young people and adults in community and hospital settings. The update contains editorial changes and transferred the guideline from the MAGICapp platform to the NICE website.
The COVID-19 rapid guideline: managing the long-term effects of COVID-19 guideline has been updated. It covers covers identifying, assessing and managing the long-term effects of COVID-19, often described as 'long COVID'. The update contains presentation changes and transferred the guideline from the MAGICapp platform to the NICE website.
The Suspected sepsis: recognition, diagnosis and early management guideline has been updated. It covers the recognition, diagnosis and early management of suspected sepsis. The update makes new recommendations on risk evaluation and management of suspected sepsis for people aged 16 or over who are not and have not recently been pregnant, in mental health, ambulance and acute hospital settings.
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 January 2024 (PDF).
This issue notifies clinicians of the new safety and educational materials to support regulatory measures to reduce the harms from valproate in men and women under 55 years of age. This includes a patient information leaflet, a patient guide and an information page that collects all resources in one place.
This issue also advises clinicians that systemic fluoroquinolone antibiotics must now only be prescribed when other commonly recommended antibiotics are inappropriate. The MHRA has recently reviewed the existing measures in place to encourage safe prescribing and has now taken additional regulatory actions to update prescribing information for all systemic fluoroquinolones.
Also this month, clinicians are notified that systematic reviews and meta-analyses of randomised controlled trials have highlighted a dose-dependent increased risk of atrial fibrillation in patients using omega-3-acid ethyl ester medicines. These studies recruited patients with established cardiovascular diseases or cardiovascular risk factors but in this population the incidence of atrial fibrillation was 3.9% when active treatment was compared to placebo. It is recommended that patients are advised to seek medical attention if they develop symptoms of atrial fibrillation and if atrial fibrillation is confirmed the medicine should be discontinued permanently.
Lastly in this issue is a summary of letters to healthcare professionals in December. 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.
The Scottish Medicines Consortium (SMC) has issued its monthly advice on newly licensed medicines.
Setmelanotide (Imcivree®) has been rejected for use in the treatment of obesity and the control of hunger associated with genetically confirmed Bardet‑Biedl syndrome (BBS) in adults and children 6 years of age and above. The manufacturer failed to make a submission for this indication. In considering the product license and acquisition cost, it would be expected that this medicine would be prescribed and monitored by a specialist.
Action: Clinicians should be aware of the recommendations of the SMC. Routine use of rejected and restricted medicines should be avoided.
