New NIHR Signal Aspirin may be a follow-on option to prevent blood clots, starting five days after hip or knee surgery

New NIHR Signal Aspirin may be a follow-on option to prevent blood clots, starting five days after hip or knee surgery
Published on 5 June 2018


In a recent trial, switching to low-dose aspirin was just as effective at preventing blood clots after joint replacement surgery as continuing the anti-clotting drug rivaroxaban. Six per 1,000 people taking aspirin experienced a blood clot, compared with seven per 1,000 taking rivaroxaban. Three to five per 1,000 patients experienced major bleeding with either drug.
From the NIHR Dissemination Centrre
https://discover.dc.nihr.ac.uk/content/signal-000599/aspirin-may-be-a-follow-on-option-to-prevent-blood-clots-starting-five-days-after-surgery

New NIHR Signal Atraumatic needles reduce headaches following lumbar puncture

New NIHR Signal Atraumatic needles reduce headaches following lumbar puncture
Published on 17 April 2018


Use of atraumatic needles rather than conventional needles for lumbar puncture more than halves the rate of post-procedure headache. Moreover, this improvement does not come at the expense of procedure success rates.


From the NIHR Dissemination Centre
https://discover.dc.nihr.ac.uk/content/signal-00583/atraumatic-needles-reduce-headaches-following-lumbar-puncture

New Technology appraisal guidance [TA526] Arsenic trioxide for treating acute promyelocytic leukaemia

New Technology appraisal guidance [TA526] Arsenic trioxide for treating acute promyelocytic leukaemia
Published date: 13 June 2018  Next review: June 2021


Evidence-based recommendations on arsenic trioxide (Trisenox) for treating acute promyelocytic leukaemia in adults.
For full guidance https://www.nice.org.uk/guidance/ta526

New Technology appraisal guidance [TA525] Atezolizumab for treating locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy

Atezolizumab for treating locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy
Published date: 13 June 2018  Next review: June 2021


Evidence-based recommendations on atezolizumab (Tecentriq) for previously treated locally advanced or metastatic urothelial carcinoma in adults.
For full guidance https://www.nice.org.uk/guidance/ta525

New Technology appraisal guidance [TA524] Brentuximab vedotin for treating CD30-positive Hodgkin lymphoma

New Technology appraisal guidance [TA524] Brentuximab vedotin for treating CD30-positive Hodgkin lymphoma
Published date: 13 June 2018  Next review: June 2021


Evidence-based recommendations on brentuximab vedotin (Adcetris) for treating CD30-positive Hodgkin lymphoma in adults.
For full guidance https://www.nice.org.uk/guidance/ta524

New Technology appraisal guidance [TA523] Midostaurin for untreated acute myeloid leukaemia

New Technology appraisal guidance [TA523] Midostaurin for untreated acute myeloid leukaemia
Published date: 13 June 2018                 Next review: June 2021


Evidence-based recommendations on midostaurin (Rydapt) for untreated FLT3-mutation-positive acute myeloid leukaemia in adults.
For full guidance https://www.nice.org.uk/guidance/ta523

New Technology appraisal guidance [TA522] Pembrolizumab for untreated locally advanced or metastatic urothelial cancer when cisplatin is unsuitable

New Technology appraisal guidance [TA522] Pembrolizumab for untreated locally advanced or metastatic urothelial cancer when cisplatin is unsuitable
Published date: 13 June 2018                 Next review: More evidence on pembrolizumab is being collected, until November 2019. After this, NICE will decide whether or not to recommend it for use on the NHS and update the guidance. It will be available through the Cancer Drugs Fund until then, as part of the managed access agreement


Evidence-based recommendations on pembrolizumab (Keytruda) for untreated locally advanced or metastatic urothelial carcinoma in adults.
for full guidance https://www.nice.org.uk/guidance/ta522

New Technology appraisal guidance [TA521] Guselkumab for treating moderate to severe plaque psoriasis

New Technology appraisal guidance [TA521] Guselkumab for treating moderate to severe plaque psoriasis
Published date: 13 June 2018                   Next review: June 2021
For full guidance https://www.nice.org.uk/guidance/ta521

New Technology appraisal guidance [TA520] Atezolizumab for treating locally advanced or metastatic non-small-cell lung cancer after chemotherapy

New Technology appraisal guidance [TA520] Atezolizumab for treating locally advanced or metastatic non-small-cell lung cancer after chemotherapy
Published date: 16 May 2018  Next review: May 2021


Evidence-based recommendations on atezolizumab (Tecentriq) for locally advanced or metastatic non-small-cell lung cancer after chemotherapy in adults.
For full guidance https://www.nice.org.uk/guidance/ta520

New NICE Technology appraisal guidance [TA519] Pembrolizumab for treating locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy

New NICE Technology appraisal guidance [TA519] Pembrolizumab for treating locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy


Published date: 25 April 2018  


Evidence-based recommendations on pembrolizumab (Keytruda) for previously treated locally advanced or metastatic urothelial carcinoma in adults.


For full guidance https://www.nice.org.uk/guidance/ta519

New NICE Interventional procedures guidance [IPG609] Robot-assisted kidney transplant

New NICE Interventional procedures guidance [IPG609] Robot-assisted kidney transplant
Published date: April 2018, Next review: April 2021


Evidence-based recommendations on robot-assisted kidney transplant in adults. This involves the surgeon using a robot to help with a kidney transplant.


Read full guidance at  https://www.nice.org.uk/guidance/ipg609

Pembrolizumab for Advanced Hepatocellular Carcinoma – second line onwards

Hepatocellular Carcinoma (HCC) is the most common type of liver cancer. This type of cancer develops from the main liver cells, called hepatocytes. Treatment and survival depends on the stage at which the cancer is diagnosed. HCC is more common in people who have long‐term damage to the liver (cirrhosis) due to a viral infection or excessive alcohol intake.


http://www.io.nihr.ac.uk/report/pembrolizumab-for-advanced-hepatocellular-carcinoma-second-line-onwards/


From the NIHR Innovation Centre

Lenabasum for Diffuse Cutaneous Systemic Sclerosis

Systemic Sclerosis (SS) is a rare disease caused by the immune system attacking the tissue which lines underneath the skin and internal organs (connective tissue). The exact cause of SS is not known but it is thought to happen when immune cells attack the body’s own tissues leading to the cells in the connective tissue producing too much collagen which causes scaring and thickening of the tissue. There are 2 types of SS; limited cutaneous SS (a milder form of SS affecting only parts of the body) and diffuse cutaneous SS (a more severe form of SS which can affect the whole body). The main symptoms of diffuse cutaneous SS are hardening of the skin, acid reflux, vomiting and diarrhoea, muscular pain, weakness and cramps. The outlook for people with diffuse cutaneous SS is generally poor due to high risk of life threatening complications such as heart, lung and kidney problems.


http://www.io.nihr.ac.uk/report/lenabasum-for-diffuse-cutaneous-systemic-sclerosis/


from the NIHR Innovation Centre

Enasidenib for Relapsed or Refractory Acute Myeloid Leukaemia (AML) with an Isocitrate Dehydrogenase 2 (IDH2) Mutation

Acute myeloid leukaemia (AML) is a type of cancer that causes the bone marrow to produce lots of immature white blood cells. It is most common in people aged 60 years and over. Symptoms of AML may include weakness, fatigue, shortness of breath, recurrent infections, prolonged bleeding, loss in appetite and unintended weight loss. Most patients with AML are treated with standard
chemotherapy.


http://www.io.nihr.ac.uk/report/enasidenib-for-relapsed-or-refractory-acute-myeloid-leukaemia-aml-with-an-isocitrate-dehydrogenase-2-idh2-mutation/


From the NIHR Innovation centre

Rigerimod plus Standard of Care for Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is a long-term condition causing inflammation to the joints, skin and other organs. Symptoms presented are usually very general, including fever, joint pain and skin rash but can progress to the most severe, e.g. kidney failure. SLE typically has patterns of flare-ups where the condition gets worse for a period of time. The disease is likely to be caused by a combination of genetic and lifestyle factors and most commonly affects middle-aged women and those of African-Caribbean ethnicity.


http://www.io.nihr.ac.uk/report/rigerimod-plus-standard-of-care-for-systemic-lupus-erythematosus/




From the NIHR Innovation Centre

Axitinib for Patients at High Risk of Recurrence of Renal Cell Carcinoma – Adjuvant

Renal cell carcinoma (RCC) is the most common type of kidney cancer. RCC affects the lining of tiny tubes within the kidney which filter waste from the blood, making urine. Symptoms include blood in urine, feeling of lump or mass in the kidney area, weight loss, raised temperature and sweating, back pain on one side (below the ribs), tiredness, loss of appetite and a general feeling of poor health. The main treatment for RCC is surgery to remove the cancer by partly or totally removing the kidney


http://www.io.nihr.ac.uk/report/axitinib-for-patients-at-high-risk-of-recurrence-of-renal-cell-carcinoma-adjuvant/


From the NIHR Innovation Centre

Tocilizumab for treating giant cell arteritis [TA 518]

New: Technology appraisal guidance


Tocilizumab for treating giant cell arteritis


Evidence-based recommendations on tocilizumab (RoActemra) for treating giant cell arteritis in adults.


https://www.nice.org.uk/guidance/ta518

Avelumab for treating metastatic Merkel cell carcinoma [TA 517]

New:  Technology appraisal guidance


Evidence-based recommendations on avelumab (Bavencio) for treating metastatic (secondary) Merkel cell carcinoma in adults.


https://www.nice.org.uk/guidance/ta517

NIHR Signal Direct acting oral anticoagulants likely to be better than warfarin for people taking them for atrial fibrillation

In people with atrial fibrillation needing anticoagulant treatment, deaths were fewer in those who had direct acting oral anticoagulants compared with warfarin. The picture is less clear for the risk of stroke and complications such as bleeding in the brain or gut. Apixaban had the best efficacy and safety profile and was cost-effective compared with warfarin.




From the NIHR Dissemination Centre

Strimvelis for treating adenosine deaminase deficiency–severe combined immunodeficiency [HST7]

New:  Highly specialised technologies guidance


Strimvelis is recommended, within its marketing authorisation, as an option for treating adenosine deaminase deficiency–severe combined immunodeficiency (ADA–SCID) when no suitable human leukocyte antigen-matched related stem cell donor is available.