NICE approval for new overactive bladder and diabetes drugs

First-in-class treatments for overactive bladder and type 2 diabetes can now be prescribed on the NHS, NICE has decided.

Mirabegron causes relaxation of smooth muscle in the bladder, enhancing urine storage.
Mirabegron causes relaxation of smooth muscle in the bladder, enhancing urine storage.

In guidance issued today, the Institute recommends the beta 3 agonist mirabegron (Betmiga) as an option for treating the symptoms of overactive bladder when antimuscarinic drugs are contraindicated or ineffective, or have unacceptable side-effects.

Dapagliflozin (Forxiga), the first licensed SGLT2 inhibitor, is recommended in combination with metformin as an option for treating type 2 diabetes when:

  • glycaemic control remains or becomes inadequate on metformin alone, and
  • the person is at significant risk of hypoglycaemia or its consequences, or sulfonylureas are contraindicated or not tolerated.

Dapagliflozin is also recommended in combination with insulin (with or without other antidiabetic drugs), but not for triple therapy in combination with metformin and a sulfonylurea.

There was additional approval for the thrombin inhibitor rivaroxaban (Xarelto) in the treatment of pulmonary embolism and the prevention of recurrent deep vein thrombosis and pulmonary embolism.

Jakavi and Krystexxa rejected

NICE rejected ruxolitinib (Jakavi), used to relieve splenomegaly and other symptoms in myelofibrosis, and the gout treatment pegloticase (Krystexxa), which has yet to be launched.

NICE guidance on mirabegron
NICE guidance on dapagliflozin
NICE guidance on rivaroxaban for pulmonary embolism and recurrent DVT

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