New recommendations published by the SMC

Positive opinions for a parenteral hypoglycaemic, an inhaled antibiotic and a diuretic are amongst the latest recommendations issued by the Scottish Medicines Consortium (SMC).

The recently launched antibacterial, fidaxomicin, is recommended for patients with recurrent Clostridium difficile infection on the advice of local microbiologists or infectious disease specialists | SCIENCE PHOTO LIBRARY

Medicines approved for use within NHS Scotland are as follows:

  • alteplase (Actilyse) for acute ischaemic stroke;
  • dexmedetomidine (Dexdor) for adults in intensive care requiring sedation no deeper than arousal in response to verbal stimulation;
  • eplerenone (Inspra) in addition to standard therapy to reduce the risk of cardiovascular morbidity and mortality in adults with chronic heart failure (NYHA class II) and left ventricular ejection fraction (LVEF) 30% or less;
  • exenatide (Byetta) as an adjunct to basal insulin in type 2 diabetes;
  • pegylated interferon alfa-2b (ViraferonPeg) in combination with ribavirin for chronic hepatitis C without liver decompensation in treatment-naive children 3 years of age and older and adolescents; and
  • tobramycin inhalation powder (TOBI Podhaler) for suppression of chronic pulmonary infection with Pseudomonas aeruginosa in adults and children over 6 years of age with cystic fibrosis.

The following were accepted for restricted use:

  • dexamethasone intravitreal implant (Ozurdex) for patients with macular oedema following central retinal vein occlusion, or for patients with branch retinal vein occlusion who are clinically unsuitable for laser treatment (including those with dense macular haemorrhage) or if laser treatment has previously failed;
  • fidaxomicin (Dificlir) for Clostridium difficile infection. Use is restricted to first recurrence in adults and only on the advice of local microbiologists or infectious disease specialists;
  • golimumab (Simponi) for active and progressive psoriatic arthritis in adults when the response to at least two DMARDs has been inadequate. Use is restricted to a monthly dose of 50mg;
  • rufinamide oral suspension (Inovelon) for the adjunctive treatment of patients 4 years of age or older with seizures associated with Lennox-Gastaut syndrome. It is restricted to use in patients who have failed, or are intolerant of, other antiepileptic treatments; and
  • tadalafil (Adcirca) for adults with pulmonary arterial hypertension (WHO class II and III). It is restricted to use by specialists working in the Scottish Pulmonary Vascular Unit or similar specialists.

Two medicines were rejected:

  • belatacept (Nulojix) used to prevent graft rejection following renal transplantation; and
  • thiotepa (Tepadina), a cytotoxic.

Further information: The Scottish Medicines Consortium

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