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An independent committee at the National Institute for Health and Care Excellence (NICE) has developed a menu of options to treat depression in adults. The first guideline to identify, treat and manage depression has been created after looking at the evidence of treatment on various aspects of depression. The guideline allows patients to select the best suited cure for them through a shared decision-making process between them and their healthcare practitioner. Patients with less severe depression can choose a first-line treatment option from the menu, such as cognitive behavioural therapy (CBT), exercise, counselling or psychotherapy. Similarly, those with a severe depression can select from a range of psychological interventions and antidepressant medication. As per data released by the Office of National Statistics, around 17 per cent of people aged 16 years and over in Great Britain experienced some form of depression in summer 2021, higher than the previous year.

The National Institute for Health and Care Excellence (NICE) today issued a draft guidance recommending dapagliflozin, sold under the brand name Forxiga among others, as an option for treating certain adults with chronic kidney disease (CKD). Dapagliflozin belongs to a group of medicines called sodium glucose co-transporter-2 (SGLT2) inhibitors. It is the first SGLT2 inhibitor to be recommended through NICE's technology appraisal process for CKD. Adding dapagliflozin to current standard care has been shown to significantly reduce the risk of having declining kidney function, end-stage kidney disease, or dying from causes related to the kidneys or cardiovascular system. "Dapagliflozin is a promising treatment for certain people with chronic kidney disease and it has the potential to increase the length of time before the disease gets worse," Meindert Boysen, deputy chief executive and director of the NICE Centre for Health Technology Evaluation, said.

The Association of the British Pharmaceutical Industry (ABPI) has supported the Department of Health and Social Care's recommendation to 'aggressively expedite and roll out new medicines' that have gone through trials. The ABPI welcomes government report on cancer services in England and the opportunity it provides to refocus how the pharmaceutical industry, NHS and government can improve the lives of cancer patients. David Watson, executive director, Patient Access at the ABPI, said: "Despite progress, UK patients still have much worse five-year survival rates for many cancers than those in similar nations. Early diagnosis and fast and equal access to the latest treatments for all patients is key to reversing poor trends in NHS cancer care. "We are pleased that the report reflects concerns about variable access to cancer medicines. We support the Committee's recommendations to 'aggressively expedite and roll out new medicines' that have gone through trials and to ensure regulatory innovation results in swift uptake in the UK.

The Association of the British Pharmaceutical Industry (ABPI) has welcomed the National Institute for Health and Care Excellence's leadership in introducing a new approach to the evaluation of antibiotics. On Tuesday (12 April), NICE published a draft guidance to tackle antimicrobial resistance under which two new antimicrobial drugs - cefiderocol and ceftazidime-avibactam - became the first to be made available as part of the UK's innovative subscription-style payment model. Commenting on the announcement of the new draft guidance, Richard Torbett, chief executive of the ABPI, said: "This is an important milestone in the UK's global leadership on AMR. Antibiotics underpin modern medicine, but the increasing threat of antibiotic resistance remains one of the biggest global health challenges we face. "To tackle this, it is critical that the appropriate frameworks are in place for companies to invest the billions of pounds required to discover the new antibiotics needed for patients.

National Institute for Health and Care Excellence (NICE)'s diagnostic advisory committee has recommended the use of HM-JACKarc or OC-Sensor quantitative faecal immunochemical tests (FIT) in a draft guidance release for consultation on Wednesday (5 July). Under existing NICE guidance, FIT was already offered to some people presenting to primary care with symptoms suggestive of colorectal cancer, while others were immediately referred on the suspected cancer pathway. The new draft guidance will now see everyone receive a FIT. A sample is sent in the post to a laboratory where the amount of blood in the faeces is measured. The results are usually available within a week and people with 10 or more micrograms of haemoglobin in their faeces should then be referred for further investigation. Further assessment using colonoscopy, or CT colonography, is required to diagnose cancer. The tests cost between £4 and £5 per sample, and can correctly identify about 9 out of 10 people with colorectal cancer. The committee agreed it is important that GPs can refer people for colonoscopy without a positive FIT result if they think it is necessary and where symptoms persist. The institute believes that the recommendation of the tests should reduce the number of unnecessary colonoscopies, thus freeing up appointments for more non-urgent referrals. This should lead to 50% fewer referrals for urgent colonoscopies being made by GPs in primary care settings each year.

Modulator therapies, manufactured by Vertex Pharmaceuticals (VRTX.O), may no longer be available for new cystic fibrosis (CF) patients in the UK. A draft guidance recently published by the National Institute for Health and Care Excellence (NICE) stated that it would not recommend the use of Kaftrio, Symkevi and Orkambi on new CF patients. Kaftrio and Symkevi are currently recommended for the treatment of cystic fibrosis in patients aged 6 years and older, while Orkambi is used for patients aged 1 and older. The NICE draft guidance highlighted medicine costs and the strain on resources and finances faced by the National Health Service (NHS) as reasons for removing these drugs.

Britain's health regulator is poised to announce that hormone replacement therapy (HRT) will be made available over the counter for the first time, the Daily Telegraph has revealed. The newspaper first reported on Tuesday (February 1) that watchdogs were set to propose a reclassification of the medication so women are able to access it in a pharmacy without a prescription. Every year, some 1.5 million women experience difficult menopausal symptoms, such as hot flushes, night sweats, sleep disturbance and a variety of emotional problems. But only a tenth of them are prescribed HRT, following a consultation with a GP or specialist. According to the newspaper, the latest proposal aims to improve convenience so that women are able to access HRT more easily, without needing a GP appointment.

The National Institute for Health and Care Excellence (NICE)'s independent committee has called for more research to ensure liposuction for treatment of chronic lipoedema is safe and effective enough for use on the NHS. Lipoedema is more prevalent in women and very rarely affects men. It is characterised by an abnormal, usually symmetrical, accumulation of fat in the legs, hips, buttocks, and occasionally arms. It is a separate condition to obesity and lymphoedema. The cause of lipoedema is unknown, but hormonal changes, weight gain and genetics are thought to be involved. The size and shape of legs, and the resultant mobility issues and pain, can have a profoundly negative effect on quality of life, and physical and mental health. The interventional procedures advisory committee reviewed evidence from several sources, including eight before-and-after studies. The committee was informed that several different liposuction techniques are used and that they may have different safety and efficacy profiles.

The UK's National Institute for Health and Care Excellence (NICE) has published a draft guidance recommending the use of electroCore's gammaCore device on the National Health Service (NHS).

The Janssen Pharmaceutical Companies of Johnson & Johnson announced that the Scottish Medicines Consortium (SMC) has approved Ponvory (ponesimod) for treating adults with relapsing-remitting multiple sclerosis (RRMS) within NHS Scotland. Ponesimod offers an additional treatment choice for the ailment, which affects over 15,000 people in Scotland. Multiple sclerosis (MS) is a chronic autoimmune inflammatory disease of the central nervous system in which immune cells attack myelin, causing inflammation. The common symptoms of this disease include fatigue, balance and walking problems, numbness or tingling, dizziness and vertigo. Amanda Cunnington, director of Health Economics, Market Access, Reimbursement, Government Affairs & Patient Engagement, Janssen-Cilag Limited said: "This decision further supports our commitment to ensuring patients living with this condition have access to new treatment options to help address some of the life-long and life-limiting symptoms of MS.

The National Institute for Health and Care Excellence (NICE) has recommended first new treatment - 'romosozumab' for osteoporosis for over a decade. Thousands of people in England and Wales with severe osteoporosis who are at high risk of fracture are set to benefit from a new treatment - romosozumab - after NICE published the final draft guidance. Over 20,000 people could be eligible for the treatment according to the company. Clinical trial evidence showed that romosozumab (also known as EVENITY and made by UCB) followed by alendronic acid is more effective at reducing the risk of fractures than alendronic acid alone. Osteoporosis is a disease that causes bones to become thin and fragile. Many people with osteoporosis show no symptoms, but they may be at increased risk of fracture. Osteoporosis leads to nearly 9 million fractures around the world each year, and over 300,000 people per year attend hospitals in the UK with fractures caused by osteoporosis.

The NHS has launched plans to expand pioneering subscription-style drug contracts to develop lifesaving antibiotics of the future. It is building on its world-first pilot to incentivise the pharmaceutical industry to develop new antibiotics that could be offered to NHS patients when they need them the most. The consultation has launched almost a year to the day that contracts for two superbug-busting drugs were rolled out as part of a world-first pilot. Cefiderocol and ceftazidime-avibactam, new antibiotics manufactured by Shionogi and Pfizer respectively, were awarded world-first subscription contracts which provided the companies with a fixed annual fee based primarily on the availability of the drugs and their value to the NHS, as opposed to the volumes used. By breaking the link between the payments companies receive and the number of their antibiotics prescribed, the NHS is removing any incentive to overuse antibiotics, decreasing the risk of life-threatening infections, such as sepsis and pneumonia, becoming resistant to treatment.

The Centre for Pharmacy Post-Graduate Education (CPPE) has launched Menopause - an introduction for pharmacy professionals e-learning programme. The new Menopause: an introduction for pharmacy professionals e-learning programme aims to support pharmacist's to increase their knowledge and awareness of menopause and perimenopause, helping them to have initial conversations with those who need support. The programme teaches how to equip people experiencing menopausal symptoms with evidence-based information that allows them to make decisions about their own health management. This e-learning programme considers a range of topics, including the signs and symptoms associated with menopause and perimenopause, how a diagnosis is made and the national context supporting a growing role for pharmacy professionals in menopause care. It also discusses the benefits and risks of treatment options available, the common misconceptions that people may have about menopause and how to apply the evidence base to practice in order to help support decision making.

The National Institute for Health and Care Excellence (NICE) has released conclusive draft guidance, suggesting Pfizer's Vydura (rimegepant) as a choice for treating acute migraines in adults with or without aura. However, there is a caveat. This recommendation applies exclusively to individuals with a prior history of migraines, meeting one of the following criteria: At least 2 triptans were tried and they did not work well enough or Triptans were contraindicated or not tolerated, and nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol were tried but did not work well enough. This drug was developed by the US-based Biohaven Pharmaceuticals, acquired by Pfizer in 2022, in an $11.6 billion deal. Nurtec ODT is the commercial name for the drug in the US, while the European Union approved the drug under the name Vydura in April 2022. NICE recommended rimegepant, an oral lyophilisate (dissolving wafer) and the first oral calcitonin gene-related peptide (CGRP) receptor antagonist for acute migraine treatment, to be taken at the onset of a migraine attack. Migraine affects one in seven people in the UK, often with a debilitating impact, Pfizer UK said in a statement. The condition entails symptoms such as head pain, vomiting, nausea, altered vision, fatigue, and heightened sensitivity to light, sound, and odours.

There is no doubt that the pandemic has changed the way healthcare professionals work within the primary care setting. The advent of Covid-19 meant that we all had to rapidly modify the way we supported and met the needs of patients, some of whom saw the services they usually took for granted, virtually cease overnight. There are around 15 million people in England living with long-term health conditions including asthma. These people have the greatest healthcare needs of the whole population with 50 per cent of all GP appointments and 70 per cent of all bed days taken by this cohort of patients, and their treatment and care absorbing 70 per cent of acute and primary care budgets in England. This situation isn't going to improve any time soon. In the past, most people had a single condition, today multi-morbidity is becoming the norm. At the start of the pandemic, the Royal College of General Practice and British Medical Association issued guidance to practices on prioritising workload. This included the importance of maintaining long-term condition reviews in asthma, COPD and diabetes, along with appropriate transition of at-risk warfarin patients. These reviews were deemed as essential workstreams for patients considered to be at high risk. Traditionally, the unique skills set of a pharmacist has meant that we have played a major role in supporting these patients. I work with a team of over 90 clinical pharmacists who, in partnership with individual practices, PCNs, CCGs and STPs, help with the long-term management of people with chronic conditions. But the onset of Covid-19 meant that we now had to plug a potential gap in service provision, and quickly.

National Institute of Health and Care Excellence (NICE) has not recommended 'Tirzepatide', also known as Mounjaro, developed by Eli Lilly, in its draft guidance issued on Tuesday (27 June) for treating type 2 diabetes in adults alongside diet and exercise. The independent NICE committee recognised the importance of new treatment options given that fewer than two-thirds of the adults with type 2 diabetes have adequate glucose control when using current treatment options. Evidence submitted to the committee from clinical trials showed the use of tirzepatide at any dose resulted in better glucose control and lower weight compared with semaglutide or insulin therapy. The weight reduction was more pronounced with higher doses of tirzepatide, while the effect on glucose levels seemed less dose-dependent. Similar effects were observed against all GLP-1 receptor agonists in company's network meta-analysis, but this was uncertain. The committee have asked the company to provide more data to address the uncertainties in the clinical evidence, when compared to all relevant alternative treatments.

Head injuries are a serious matter. They can lead to long-term health problems and even death in some cases. This article will go over some unexpected scenarios that often lead to head injuries. AIRBAG DEPLOYMENT Car accidents occur often, and you probably think you're safe from minor ones if you have your seatbelt strapped in. However, many people have suffered airbag injuries from a car accident because of their position at the moment it deployed. This may not seem like a big deal, but airbags inflate quickly, at around 200 miles per hour, and with great force. If your head is too close to the airbag when it deploys, you can suffer from some serious injuries. So what can you do to avoid this? First, make sure that you're sitting in an upright position with plenty of space between you and the steering wheel. Additionally, try to keep your headrest in an upright position so that it can provide some support if an accident does occur. And finally, be aware of airbag deployment times; they typically deploy within 0.08-0.14 seconds after an impact occurs.

The National Institute for Health and Care Excellence (NICE) has recommended faricimab as treatment option for adults with wet age-related macular degeneration or diabetic macular oedema. Thousands of people in England could benefit from the recommendation of a new drug that helps to treat two leading causes of sight loss and visual impairment. Faricimab is administered as an eye injection and is being recommended as an option for treating some adults with wet age-related macular degeneration (AMD) or with diabetic macular oedema (DMO). In the key clinical trials, aflibercept, another eye injection drug used to treat AMD and DMO, was administered every 8 weeks, while faricimab dosing, based on assessments of the disease activity, allowed for an interval of up to 16 weeks between doses, and was found to be equally effective. Up to 300,000 people in England with wet age-related macular degeneration (AMD) could be eligible to receive faricimab as part of their treatment alongside just over 28,000 people with diabetic macular oedema.

NICE has recommended use of tucatinib as an option to treat HER2-positive breast cancer that has spread in people who have already tried 2 or more anti-HER2 treatments. The move is set to benefit around 400 people with advanced breast cancer. Tucatinib works by blocking a specific area of the HER2 gene in cancer cells, which stops the cells from growing and spreading. The medicine is taken as two 150 mg tablets twice daily along with anti-cancer medicines trastuzumab and capecitabine. Helen Knight, programme director in the NICE Centre for Health Technology Evaluation, said: "Unfortunately there is no cure for breast cancer that has spread to other parts of the body. There is also a lack of additional anti‑HER2 treatments which can postpone the need for chemotherapy, especially for people whose cancer has spread to their brain because their treatment options are even more limited.

The National Institute for Health and Care Excellence (NICE) has recommended icosapent ethyl also called Vazkepa manufactured by Amarin for adults who have cardiovascular disease with controlled LDL-C levels taking a statin. It's final draft guidance is expected to be available on the July 20. Nearly half a million people are expected to benefit from the first licensed treatment shown to reduce the risk of heart attacks and strokes in people with controlled low-density lipoprotein cholesterol (LDL-C - sometimes called "bad" cholesterol) who are taking a statin and who have raised levels of triglycerides. NICE said: "Clinical trial evidence suggests that for people with raised triglycerides who have LDL-C levels controlled by statins, and who have cardiovascular disease, icosapent ethyl reduces their risk of cardiovascular events by over a quarter compared with placebo. Helen Knight, interim director of medicines evaluation at NICE, said: "Icosapent ethyl is the first licensed treatment of its kind for people who are at risk of heart attacks and strokes despite well controlled LDL cholesterol because they have raised blood fats. And although lifestyle changes, including diet and exercise, can help to reduce their risk, these may not work for everyone.