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  • Question on Consultation

    Is the proposed process for updating and withdrawing the TAs appropriate to achieve useful and usable guidance?

  • Question on Consultation

    Is the proposed process sufficiently clear? Are further details of the proposed process required by stakeholders?

  • Question on Consultation

    Should NICE consider adapting other elements of the proposed process to achieve more useful and usable guidance?

  • Question on Consultation

    Do you have any other comments on the proposed process for updating the TAs within the proportionate decision-making process?

  • Question on Consultation

    Would it be challenging to implement of any of the recommendations for the updated TAs? Please say why and for whom, and how these could be mitigated.

  • Question on Consultation

    Would implementation of any of the recommendations have significant cost implications?

Review proposal of TA288, TA315, TA336, TA390, TA418, TA572, TA583

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Summary of TAs to be considered for review

A summary of the TAs to be considered for review is listed in Table 1.

Table 1: TAs to be considered for review

TA number

Title

Recommendation

Year of publication

TA288

Dapagliflozin in combination therapy for treating type 2 diabetes

Dapagliflozin in a dual therapy regimen in combination with metformin is recommended as an option for treating type 2 diabetes, only if:

  • a sulfonylurea is contraindicated or not tolerated or

  • the person is at significant risk of hypoglycaemia or its consequences.

Dapagliflozin in combination with insulin with or without other antidiabetic drugs is recommended as an option for treating type 2 diabetes.

2013

TA315

Canagliflozin in combination therapy for treating type 2 diabetes

Canagliflozin in a dual therapy regimen in combination with metformin is recommended as an option for treating type 2 diabetes, only if:

  • a sulfonylurea is contraindicated or not tolerated or

  • the person is at significant risk of hypoglycaemia or its consequences.

Canagliflozin in a triple therapy regimen is recommended as an option for treating type 2 diabetes in combination with:

  • metformin and a sulfonylurea or

  • metformin and a thiazolidinedione.

Canagliflozin in combination with insulin with or without other antidiabetic drugs is recommended as an option for treating type 2 diabetes.

2014

TA336

Empagliflozin in combination therapy for treating type 2 diabetes

Empagliflozin in a dual therapy regimen in combination with metformin is recommended as an option for treating type 2 diabetes, only if:

  • a sulfonylurea is contraindicated or not tolerated, or

  • the person is at significant risk of hypoglycaemia or its consequences.

Empagliflozin in a triple therapy regimen is recommended as an option for treating type 2 diabetes in combination with:

  • metformin and a sulfonylurea or

  • metformin and a thiazolidinedione.

Empagliflozin in combination with insulin with or without other antidiabetic drugs is recommended as an option for treating type 2 diabetes.

2015

TA390 (MTA)

Canagliflozin, dapagliflozin and empagliflozin as monotherapies for treating type 2 diabetes

Canagliflozin, dapagliflozin and empagliflozin as monotherapies are recommended as options for treating type 2 diabetes in adults for whom metformin is contraindicated or not tolerated and when diet and exercise alone do not provide adequate glycaemic control, only if:

  • a dipeptidyl peptidase‑4 (DPP‑4) inhibitor would otherwise be prescribed and

  • a sulfonylurea or pioglitazone is not appropriate.

2016

TA418

Dapagliflozin in triple therapy for treating type 2 diabetes

Dapagliflozin in a triple therapy regimen is recommended as an option for treating type 2 diabetes in adults, only in combination with metformin and a sulfonylurea.

2016

TA572

Ertugliflozin as monotherapy or with metformin for treating type 2 diabetes

Ertugliflozin as monotherapy is recommended as an option for treating type 2 diabetes in adults for whom metformin is contraindicated or not tolerated and when diet and exercise alone do not provide adequate glycaemic control, only if:

  • a dipeptidyl peptidase 4 (DPP‑4) inhibitor would otherwise be prescribed and

  • a sulfonylurea or pioglitazone is not appropriate.

Ertugliflozin in a dual-therapy regimen in combination with metformin is recommended as an option for treating type 2 diabetes, only if:

  • a sulfonylurea is contraindicated or not tolerated or

  • the person is at significant risk of hypoglycaemia or its consequences.

If patients and their clinicians consider ertugliflozin to be 1 of a range of suitable treatments including canagliflozin, dapagliflozin and empagliflozin, the least expensive should be chosen.

2019

TA583

Ertugliflozin with metformin and a dipeptidyl peptidase-4 inhibitor for treating type 2 diabetes

Ertugliflozin with metformin and a dipeptidyl peptidase‑4 (DPP‑4) inhibitor is recommended as an option for treating type 2 diabetes in adults when diet and exercise alone do not provide adequate glycaemic control, only if:

  • the disease is uncontrolled with metformin and a DPP‑4 inhibitor, and

  • a sulfonylurea or pioglitazone is not appropriate.

If patients and their clinicians consider ertugliflozin to be 1 of a range of suitable treatments, including canagliflozin, dapagliflozin and empagliflozin, the least expensive should be chosen.

2019