During July 2025 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 Immunizations - childhood topic has been updated in line with the current national immunisation guidance from the UK Health Security Agency. The Immunizations - travel has been updated to include a new section on dengue and dengue vaccination and other recommendations have been updated in line with the latest guidance from the UK Health Security Agency (UKHSA) and the National Travel Health Network and Centre (NaTHNaC). The Jaundice in adults topic has been updated replacing the term non-alcoholic fatty liver disease (NAFLD) with metabolic dysfunction-associated steatotic liver disease (MASLD) in line with international consensus.
Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.
The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of July 2025. This month there are two technology appraisals and one health technology evaluation that impact upon primary care.
The Dapagliflozin for treating chronic kidney disease technology appraisal has been published. This treatment is recommended as an option to treat chronic kidney disease (CKD) in adults, if:
- it is an add-on to optimised standard care including the highest tolerated licensed dose of angiotensin-converting enzyme (ACE) inhibitors or angiotensin‑2 receptor antagonists, unless these are contraindicated, and
- people have an estimated glomerular filtration rate (eGFR) 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 Cenobamate for treating focal onset seizures in epilepsy technology appraisal has been updated. As reported in May, amendments to some recommendations were made to reduce inequity of access to the treatment. This update has amended the 'why the committee made these recommendations' section to reflect the updated recommendations.
The One-piece closed bags for colostomies: late-stage assessment health technology evaluation has been published. This is a late stage assessment, an approach to evaluate technologies that are already in widespread use within the NHS. It is noted that there is not enough evidence to determine whether price variation is justified between different one-piece closed bags for adults with a colostomy. It is recommended that stoma care services should have access to a broad range of one-piece closed bags available for prescription in the NHS, so that adults with a colostomy can have the most appropriate bag for them. A joint decision between a healthcare professional and the person with a colostomy should take into account clinical appropriateness and the person with a colostomy's needs and preferences. Where more than one product is suitable, the least expensive option should be used.
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 a Drug Safety Update article for July 2025.
This update warns clinicians about a small increase in the risk of Guillain-Barré syndrome following vaccination with respiratory syncytial virus (RSV) vaccine (Abrysvo® or Arexvy®) in adults aged 60 years and older. There have been 21 case reports submitted to the MHRA on a background of almost 2 million delivered doses. There is currently no evidence of increased risk in pregnant women. Abrysvo is the vaccine in use in the NHS but data from the United States indicates this issue may also affect Arexvy.
Older patients in the NHS Immunisation cohort (aged 75-79years old) should be warned to seek urgent medication attention should they develop neurological symptoms. This would include tingling, numbness or pins and needles usually followed by muscle weakness and difficultly moving joints.
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.
Fezolinetant (Veoza®) has been rejected for use in the treatment of moderate to severe vasomotor symptoms (VMS) associated with menopause. The submitting company did not present a sufficiently robust economic analysis to gain acceptance by SMC.
Abaloparatide (Eladynos®) has been accepted for restricted use in the treatment of osteoporosis in postmenopausal women at increased risk of fracture. The restriction limits use to patients at very high risk of fracture, assessed using a validated fracture risk assessment tool. This advice also applies only in the context of approved NHSScotland Patient Access Scheme and as such it would be expected that this item would be prescribed in secondary care.
Action: Clinicians should be aware of the recommendations of the SMC. Routine use of rejected and restricted medicines should be avoided.
During June 2025 Clinical Knowledge Summaries were published or updated in the following areas.
The Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) topic is new. All of the topics have been reviewed and updated with minor structural and layout changes. The Hand, foot, and mouth disease topic has been updated with a new recommendation to consider the use of topical oromucosal antiseptics or anaesthetics in the management advice section. The Immunizations - seasonal influenza topic has been updated to align with the NHS immunisation programme 2025 to 2026.
Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.
