Author: Gavin Mankin

The decisions made at the NENC Medicines Subcommittee June 2023 meeting can now be found at: https://ntag.nhs.uk/meetings/decision-summaries/

This includes the recommendations made by NTAG in May 2023 meeting and NICE Technology appraisals from the 1st February 2023 to 31st March 2023.

The following guidelines/position statements were approved and can be found at:

• NENC Decision Aid for DOACs for Atrial Fibrillation – review date extended for further 12 months. https://ntag.nhs.uk/recommendations/cardiovascular-system-recommendations/
• NENC regional guidance on type 2 diabetes https://ntag.nhs.uk/recommendations/endocrine-system-recommendations/
• NENC Dronedarone shared care guideline https://ntag.nhs.uk/recommendations/cardiovascular-system-recommendations/
• NENC Sativex® shared care guideline for the treatment of spasticity in multiple sclerosis https://ntag.nhs.uk/recommendations/central-nervous-system-recommendations/
• NENC Commmissioning policy for Baricitinib for patients hospitalised due to COVID-19 (adults and children aged 2 years and over) https://ntag.nhs.uk/recommendations/miscellaneous-recommendations/
• NENC Penicillin Allergy Assessment Oral Challenge and De-labelling Secondary Care https://ntag.nhs.uk/recommendations/miscellaneous-recommendations/

The decisions made at the NENC Medicines Subcommittee April 2023 meeting can now be found at: https://ntag.nhs.uk/meetings/decision-summaries/

This includes the recommendations made by NTAG in March 2023 meeting and NICE Technology appraisals from the 1st January 2023 to 31st January 2023.

The following guidelines/position statements were approved and can be found at:
• NENC regional guidance On SGLT2 inhibitors – supersedes previous versions for CKD, heart failure and type 2 diabetes
https://ntag.nhs.uk/recommendations/endocrine-system-recommendations/

• NENC ICB position statement – nonpalliative care use of opiates
https://ntag.nhs.uk/recommendations/central-nervous-system-recommendations/

Drugs with a NICE recommendation published in February and March 2023 have been considered by NTAG in its May meeting, and will be considered for approval by Medicines Subcommittee at its June 2023 meeting.

All approved NENC Medicines Subcommittee and NTAG meeting minutes can be found at: https://ntag.nhs.uk/meetings/ntag-meetings/ and https://ntag.nhs.uk/meetings/nenc-medicines-committee-meetings/

The latest NEELI Guidelines have now been published on the NTAG website.

The July 2022 Minutes are now available on the site.

The work plan of the group has been updated.

The NENC Renal Network SGLT2-inhibitors and Chronic Kidney Disease – patient information leaflet is now available on the site

The June 2022 Minutes are now available on the site.

The work plan of the group has been updated.

The NTAG Terms of Reference have been updated and are available on the website.

What Treatments will NTAG Consider – this guidance has been updated and is available on the website.

NTAG Checklist for Appraisal of Clinical Evidence – this guidance has been updated and is available on the website.

The following recommendations were approved by NTAG at their meeting on the 7th June 2022 and are now available on the website:

• NTAG Biosimilars Statement – new recommendation supporting the use of biosimilars.
• Budesonide orodispersible for maintenance treatment of eosinophilic oesophagitis – new recommendation.
• iPORT advance – updated to also include a limited cohort of type 2 diabetes patients.
• Liposuction for lipoedema and lymphoedema – updated to make reference to latest NICE Interventional Procedures Guidance – no change to the actual recommendation itself.
• Flash Glucose Monitoring – updated to reflect latest NICE guidance on glucose monitoring. Has been sent to NENC Value Based Commissioning Group to consider updating the regional VBC policy and overall CGM policy.
• Dapagliflozin in CKD Top Tips – new regional document.
• SGLT2 in Heart failure Top Tips – new regional document.
• SGLT2 in Type 2 Diabetes – updated version approved. Replaces versions previously approved individually by APCs.
• NENC Patient Specific Factors to Consider When Choosing a DOAC in NVAF Decision Aid – new regional document.

The February 2022 Minutes are now also available on the site.

The work plan of the group has been updated.

The revised meeting dates for 2022 have been added to the site.

The NTAG Annual Report 2021/22 has been added to the site.

The following recommendations were updated by NTAG at their meeting on the 22^nd February 2022 and are now available on the website:

• Infliximab subcutaneous injection (Remsima SC ®) – Recommended as an option during Covid-19 Pandemic. To be reviewed again once ICS structures and Tariff arrangements confirmed post-pandemic.
• Alfapump® device for the treatment of ascites due to Liver Cirrhosis – Reviewed and no changes made
• Pitolisant (Wakix®) for the treatment of narcolepsy with or without cataplexy in adults – Reviewed and added reference to NICE TA for Solriamfetol. No other changes made
• i-Port Advance® for use in children and adults with Type 1 diabetes – Reviewed and no changes made. Remains not approved for use in Type 2 diabetes.
• Ulipristal (Ellaone®) for post-coital (up to 120 hours) contraception – Reviewed and added links to FSRH Guidance. No other changes made.
• Actipatch® for management of localised musculoskeletal pain – Reviewed and no changes made that not recommended.

The following recommendations were archived by NTAG at their meeting on the 22^nd February 2022 as now superseded by NICE TA or NHSE guidance:

• Solriamfetol for narcolepsy in adults – Superseded NICE TA available

The September 2021 Minutes are now also available on the site.

The work plan of the group has been updated.

The membership of the group has been updated to reflect the current membership.

The meetings for 2022 have been added to the website.

The following recommendations were updated by NTAG at their meeting on the 23rd February 2021 and are now available on the website:

• Flash Glucose Monitoring – updated to include Learning Disability on insulin, and use in pregnancy on insulin with Type 2 diabetes as additional criteria. Plus information on switch to Freestyle Libre 2 and extra guidance on use in Type 1 diabetes patient with high HbA1c.
• Teriparatide for atypical bisphosphonate induced fractures – reviewed and no changes made.
• Doxylamine/Pyridoxine (Xonvea®) for nausea & vomiting in pregnancy – reviewed and no changes made.

The recommendations were archived by NTAG at their meeting on the 23rd February 2021 as now superseded by NICE TA or NHSE guidance:

• Erenumab and galcanezumab for prophylaxis of migraine
• Brolucizumab for wAMD

The following recommendations were updated by NTAG at their meeting on the 8th June 2021 and are now available on the website:

• Perampanel (Fycompa^®) for Partial-onset (focal) epilepsy – updated recommendation to include license extension in children under 12 years old.
• Transanal Irrigation Systems (TAIs) for neurogenic bowel dysfunction, chronic constipation, and chronic faecal incontinence – updated to replace Peristeen with Peristeen Plus as Peristeen discontinued by manufacturer.
• Infliximab Subcutaneous (Remsima^®) –  reviewed and no change to recommendation that is an option during Covid-19 Pandemic. To be reviewed in 6 months.
• Dupilumab and Omalizumab for chronic rhinosinusitis with nasal polyps –  updated to note that not recommended as NICE TA terminated.
• Transcutaneous vagus nerve stimulation for treatment of cluster headache and migraine –  updated to reflect change in funding arrangements. Now CCG commissioned and funded.

The recommendations were archived by NTAG at their meeting on the 8th June 2021 as now superseded by NICE TA or NHSE guidance:

• Andexanet alfa (Ondexxya^®) Factor Xa inhibitor antidote

12/10/2021

The following recommendations were updated by NTAG at their meeting on the 7th September 2021 and are now available on the website:

• Lurasidone (Latuda®) for the treatment of schizophrenia in adults and adolescents aged 13 years and over – updated recommendation recommending use as an option as per criteria specified in recommendation, and also including use in adolescents.
• Daily vs on-demand PDE-5 inhibitors for management of erectile dysfunction following treatment for prostate cancer – updated recommendation that once daily oral 5mg tadalafil may be considered as an option for the management of erectile dysfunction following treatment for prostate cancer. Oral 2.5mg tadalafil is not recommended by NTAG for this indication on the basis of cost.
• Buprenorphine prolonged release injection for opioid dependence – new recommendation that an alternative option for the management of opioid dependence after oral methadone and/or oral buprenorphine.

The June 2021 Minutes are now also available on the site.

The work plan of the group has been updated.