Navigation

Summary of guidance relevant to general practice in April 2012

Fingolimod for multiple sclerosis (replasing/remitting)

Patients with relapsing remitting multiple sclerosis can now be offered a pill that helps reduce the number of relapses, says NICE.

Fingolimod (Gilenya) is the first pill-based medicine for the treatment of RRMS, and works by preventing white blood cells from attacking nerve cells in the brain and spinal cord.

In final guidance, NICE says the drug can be used for adults with RRMS who have an unchanged or increased relapse rate, or ongoing severe relapses in comparison with the previous year, despite taking beta interferons.

NICE also says that people with RRMS who currently receive fingolimod, but whose disease does not meet these criteria, should be able to continue receiving the drug until they and their doctors decide it is appropriate to stop.

NICE says its recommendation for the use of fingolimod only applies if the drug manufacturer provides the drug at a confidential discounted price.

This has been proposed in the manufacturer's patient access scheme. These are schemes that pharmaceutical companies suggest as part of the development of a NICE technology appraisal in order to reduce the cost to the NHS so that the drugs become cost effective.

Support tools to help you put this guidance into practice

NICE has produced a clinical audit tool, costing template and electronic audit tool to help with this guidance.

Boceprevir and Telaprevir for Hepatitis C

NICE has recommended the use of boceprevir (Victrelis) and telaprevir (Incivo), both in combination with peginterferon alfa and ribavirin, as options for the treatment of the most common strain of hepatitis C in adults, in latest guidance.

Genotype 1 is the most common subtype of hepatitis C in England and Wales affecting around half of people with hepatitis - and is the most resistant to treatment.

Poor diagnosis rates, low treatment compliance rates and a high annual incidence of new infection mean that chronic hepatitis C presents a major public health challenge, despite the availability of treatments that provide the opportunity to address this challenge.

This latest guidance recommends boceprevir and telaprevir as options for the treatment of people with genotype 1 chronic hepatitis C, in combination with peginterferon alfa and ribavirin, in adult patients with compensated liver disease who are previously untreated or in whom previous treatment has failed.

Both boceprevir and telaprevir work by inhibiting the activity of the NS3/4A serine protease. This protease is essential for viral replication and may be partially responsible for the ability of the hepatitis C virus to evade clearance by the host immune system.

The drugs are administered orally three times a day. Clinical trials have demonstrated that treatment with boceprevir or telaprevir plus pegylated interferon and ribavirin, produces higher sustained virological response rates (considered to be equivalent to a cure) than pegylated interferon and ribavirin combination therapy.

Support tools to help you put this guidance into practice

NICE has produced a clinical audit tool and a costing template for boceprevir and a clinical audit tool and a costing template for telaprevir.

25 April 2012

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.

Selected, reliable information for health and social care in one place

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.