NICE recommends lung infection treatments for patients with cystic fibrosis
Patients with cystic fibrosis can now be offered tobramycin (Novartis) and colistimethate sodium (Forest Laboratories UK) dry powders for inhalations as treatment options for lung infections in certain circumstances, following final guidance from NICE.
Cystic fibrosis currently affects around 8,000 people in the UK. Patients who have the condition are prone to lung infections by a range of pathogens, such as Pseudomonasaeruginosa.
P aeruginosa is the most common cause of infection for patients with cystic fibrosis, and occurs in around 38 per cent of cases. The length and quality of life of people with cystic fibrosis are thought to be strongly influenced by the degree to which this bacterium can be eradicated, yet it is rarely completely destroyed.
Tobramycin DPI is inhaled using a breath-activated, hand-held device, and works by decreasing the amount of P aeruginosa in the lungs.
NICE says that tobramycin can be used as a treatment option for chronic pulmonary infection caused by P aeruginosa in people with cystic fibrosis under certain conditions.
These conditions includewhen nebulised colistimethate sodium is contraindicated, not tolerated or has not produced an adequate clinical response.
Colistimethate DPI is recommended as an option for treating chronic pulmonary infection caused by P aeruginosa in people with cystic fibrosis, only if they would clinically benefit from continued colistimethate sodium but do not tolerate it in its nebulised form, and thus tobramycin therapy would otherwise be considered.
Colistimethate sodium DPI is also inhaled with a breath-activated, hand-held device. It works by disrupting the structure of bacterial cells, which kills the bacteria.
Both drugs should be made available by the manufacturers at a discounted price agreed as part of the patient access scheme to primary, secondary and tertiary care in the NHS.
Professor Carole Longson, Health Technology Evaluation Centre Director at NICE said: "The primary cause of death in people with cystic fibrosis is respiratory failure resulting from chronic pulmonary infection caused by P aeruginosa."
“We are pleased to recommend both colistimethate sodium and tobramycin dry powders for inhalation as options for treating such infections in people with cystic fibrosis."
27 March 2013