Showing posts with label respiratory. Show all posts
Showing posts with label respiratory. Show all posts
Wednesday, 13 June 2018
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:
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
Wednesday, 21 March 2018
NIHR Signal Statins are of no benefit in acute respiratory distress syndrome
NIHR Signal Statins are of no benefit in acute respiratory distress syndrome
Giving statins to patients with acute respiratory distress syndrome made no difference to the number of days they spent on a ventilator. It also had no effect on mortality or the length of time spent in intensive care or in hospital compared with placebo.
Published on 13 March 2018
Read full document at https://discover.dc.nihr.ac.uk/portal/article/4000971/statins-are-of-no-benefit-in-acute-respiratory-distress-syndrome
Giving statins to patients with acute respiratory distress syndrome made no difference to the number of days they spent on a ventilator. It also had no effect on mortality or the length of time spent in intensive care or in hospital compared with placebo.
Published on 13 March 2018
Read full document at https://discover.dc.nihr.ac.uk/portal/article/4000971/statins-are-of-no-benefit-in-acute-respiratory-distress-syndrome
Tuesday, 6 February 2018
Pirfenidone for treating idiopathic pulmonary fibrosis [TA 504]
New: Technology appraisal guidance
https://www.nice.org.uk/guidance/ta504Pirfenidone is recommended as an option for treating idiopathic pulmonary fibrosis in adults only if:
- the person has a forced vital capacity (FVC) between 50% and 80% predicted
- the company provides pirfenidone with the discount agreed in the patient access scheme and
- treatment is stopped if there is evidence of disease progression (an absolute decline of 10% or more in predicted FVC within any 12‑month period).
Pirfenidone (Esbriet, Roche) is an oral immunosuppressant with anti-inflammatory and antifibrotic effects.
Monday, 29 January 2018
Sore throat (acute): antimicrobial prescribing [NG 84]
New: NICE guideline
acute sore throat (including pharyngitis and tonsillitis) is self‑limiting and often triggered by a viral infection of the upper respiratory tract
acute sore throat (including pharyngitis and tonsillitis) is self‑limiting and often triggered by a viral infection of the upper respiratory tract
symptoms can last for around 1 week, but most people will get better within this time without antibiotics, regardless of cause (bacteria or virus).
Assess and manage children under 5 who present with fever as outlined in the NICE guideline on fever in under 5s.
Friday, 26 January 2018
Lung cancer patients living for longer than ever
A new report published by the Royal College of Physicians (RCP) finds that more lung cancer patients are living for longer than ever, with 37% of patients alive at least 1 year after diagnosis compared to a rate of 31% in 2010.
The National Lung Cancer Audit (NLCA) 2017 annual report finds more cancers are being diagnosed at an earlier stage, with one in eight lung cancers found at the very earliest stage.
There has been a rise in diagnosis in patients aged over 70, the age group in which most lung cancer is present. There has been a rise of 5% more diagnoses in this age group since 2007.
The National Lung Cancer Audit (NLCA) 2017 annual report finds more cancers are being diagnosed at an earlier stage, with one in eight lung cancers found at the very earliest stage.
There has been a rise in diagnosis in patients aged over 70, the age group in which most lung cancer is present. There has been a rise of 5% more diagnoses in this age group since 2007.
Pneumococcal: the green book, chapter 25
Chapter 25 of the Green Book on pneumococcal has been updated.
Wednesday, 24 January 2018
NIHR Signal Blood test reduces mortality and shortens antibiotic use among adults with chest infection
It may be feasible to use procalcitonin blood levels to guide antibiotic treatment for adults in hospital with a suspected chest infection. By measuring procalcitonin, an indicator of bacterial infection, clinicians could review their diagnosis earlier.
This reduced antibiotic exposure by 2.5 days with fewer adverse effects and also less mortality. About 14 extra people in every 1,000 who had their management guided by the blood test would be expected to survive the first month, compared with those receiving standard care without this test.
From the NIHR Dissemination Centre
This reduced antibiotic exposure by 2.5 days with fewer adverse effects and also less mortality. About 14 extra people in every 1,000 who had their management guided by the blood test would be expected to survive the first month, compared with those receiving standard care without this test.
From the NIHR Dissemination Centre
Ceritinib for untreated ALK-positive non-small-cell lung cancer [TA 500]
New: Technology appraisal guidance
Ceritinib is recommended, within its marketing authorisation, as an option for untreated anaplastic lymphoma kinase (ALK)‑positive advanced non-small-cell lung cancer in adults, only if the company provides it with the discount agreed in the patient access scheme.
Why the committee made this recommendation
Most people with untreated ALK‑positive advanced non-small-cell lung cancer are offered crizotinib. Chemotherapy may be offered if the person's ALK mutation status isn't known, and therefore is not a relevant comparator for ceritinib. There are no trials directly comparing ceritinib with crizotinib; the clinical trial compares ceritinib with chemotherapy.
Because the clinical trial has not finished, it is unable to show how much ceritinib prolongs life compared with chemotherapy. But it shows that ceritinib is more effective than chemotherapy at increasing the length of time people live without their disease progressing. An indirect comparison suggests that ceritinib is more effective than crizotinib. Clinical experts support using ceritinib instead of crizotinib.
Ceritinib is recommended, within its marketing authorisation, as an option for untreated anaplastic lymphoma kinase (ALK)‑positive advanced non-small-cell lung cancer in adults, only if the company provides it with the discount agreed in the patient access scheme.
Why the committee made this recommendation
Most people with untreated ALK‑positive advanced non-small-cell lung cancer are offered crizotinib. Chemotherapy may be offered if the person's ALK mutation status isn't known, and therefore is not a relevant comparator for ceritinib. There are no trials directly comparing ceritinib with crizotinib; the clinical trial compares ceritinib with chemotherapy.
Because the clinical trial has not finished, it is unable to show how much ceritinib prolongs life compared with chemotherapy. But it shows that ceritinib is more effective than chemotherapy at increasing the length of time people live without their disease progressing. An indirect comparison suggests that ceritinib is more effective than crizotinib. Clinical experts support using ceritinib instead of crizotinib.
Plasma EGFR mutation tests for adults with locally advanced or metastatic non-small-cell lung cancer [MIB 137}
New: Medtech innovation briefing
Epidermal growth factor receptor (EGFR) mutation tests are in vitro diagnostic (IVD) tests used to help identify adults with non-small-cell lung cancer (NSCLC) suitable for treatment with EGFR tyrosine kinase inhibitors (EGFR‑TKIs). The presence of specific EGFR mutations show how effective treatment with EGFR‑TKIs will be. As a result, the test is useful for oncologists for deciding personalised treatment options.
EGFR mutations occur in EGFR exons 18–21 and mutations in exons 18, 19 and 21 and indicate suitability for treatment with EGFR‑TKIs. Mutations in exon 20 (with the exception of a few mutations) show the tumours are EGFR‑TKI resistant and not suitable for treatment with EGFR‑TKIs.
Epidermal growth factor receptor (EGFR) mutation tests are in vitro diagnostic (IVD) tests used to help identify adults with non-small-cell lung cancer (NSCLC) suitable for treatment with EGFR tyrosine kinase inhibitors (EGFR‑TKIs). The presence of specific EGFR mutations show how effective treatment with EGFR‑TKIs will be. As a result, the test is useful for oncologists for deciding personalised treatment options.
EGFR mutations occur in EGFR exons 18–21 and mutations in exons 18, 19 and 21 and indicate suitability for treatment with EGFR‑TKIs. Mutations in exon 20 (with the exception of a few mutations) show the tumours are EGFR‑TKI resistant and not suitable for treatment with EGFR‑TKIs.
Tuesday, 23 January 2018
Latest Avian influenza (bird flu) updates Winter 2017 to 2018
Avian influenza (bird flu), a disease of birds, has been identified in wild birds in England in 2018. All poultry keepers should review their biosecurity, sign up for disease alerts, and register their birds with APHA. Keepers must report any unexplained deaths or sickness to their vet.
Public Health England advises the risk to public health from H5N8 and H5N6 avian influenza is very low and the Food Standards Agency has said the disease poses no food safety risk for UK consumers.
Read the latest updates in full at https://www.gov.uk/government/news/avian-influenza-bird-flu-in-winter-2017-to-2018
Thursday, 18 January 2018
Bird flu prevention zone extended to cover whole of England
A bird flu prevention zone has been declared across the whole of England, Chief Veterinary Officer Nigel Gibbens has confirmed today.
This means it is a legal requirement for all bird keepers to follow strict biosecurity measures. It comes as 13 dead wild birds were confirmed to have the virus in Warwickshire.
https://www.gov.uk/government/news/bird-flu-prevention-zone-extended-to-cover-whole-of-england
This means it is a legal requirement for all bird keepers to follow strict biosecurity measures. It comes as 13 dead wild birds were confirmed to have the virus in Warwickshire.
https://www.gov.uk/government/news/bird-flu-prevention-zone-extended-to-cover-whole-of-england
Wednesday, 17 January 2018
NIHR Signal Blood test reduces mortality and shortens antibiotic use among adults with chest infection
It may be feasible to use procalcitonin blood levels to guide antibiotic treatment for adults in hospital with a suspected chest infection. By measuring procalcitonin, an indicator of bacterial infection, clinicians could review their diagnosis earlier.
This reduced antibiotic exposure by 2.5 days with fewer adverse effects and also less mortality. About 14 extra people in every 1,000 who had their management guided by the blood test would be expected to survive the first month, compared with those receiving standard care without this test.
From the NIHR Dissemination Centre
This reduced antibiotic exposure by 2.5 days with fewer adverse effects and also less mortality. About 14 extra people in every 1,000 who had their management guided by the blood test would be expected to survive the first month, compared with those receiving standard care without this test.
From the NIHR Dissemination Centre
Friday, 12 January 2018
Chronic Obstructive Pulmonary Disease (COPD) Pathway
The Chronic Obstructive Pulmonary Disease (COPD) Pathway defines the core components of an optimal service for people with COPD.
The NHS RightCare Pathway for COPD provides a national case for change and a set of resources to support local health economies to concentrate their improvement efforts where there is greatest opportunity to address variation and improve population health.
The NHS RightCare Pathway for COPD provides a national case for change and a set of resources to support local health economies to concentrate their improvement efforts where there is greatest opportunity to address variation and improve population health.
Friday, 29 December 2017
NIHR Signal A strategy of 'delayed antibiotic prescribing' for respiratory infections may reduce antibiotic use
Delaying antibiotic prescribing made little difference to most symptoms of respiratory infection. It reduced antibiotic use and did not affect patient satisfaction compared with immediate prescribing of antibiotics.
Increasing antibiotic resistance is a global health concern. Many people don’t realise that viruses cause most respiratory infections and that antibiotics won’t help. The strategy allows some time for symptoms to improve naturally.
From the NIHR Dissemination Centre
Increasing antibiotic resistance is a global health concern. Many people don’t realise that viruses cause most respiratory infections and that antibiotics won’t help. The strategy allows some time for symptoms to improve naturally.
From the NIHR Dissemination Centre
Wednesday, 27 December 2017
Endobronchial valve insertion to reduce lung volume in emphysema [IPG600]
New interventional procedures guidance from NICE. Endobronchial valve insertion to reduce lung volume in emphysema.
Current evidence on the safety and efficacy of endobronchial valve insertion to reduce lung volume in emphysema is adequate in quantity and quality to support the use of this procedure provided that standard arrangements are in place for clinical governance, consent and audit.
Patient selection should be done by a multidisciplinary team experienced in managing emphysema, which should typically include a chest physician, a radiologist, a thoracic surgeon and a respiratory nurse.
Current evidence on the safety and efficacy of endobronchial valve insertion to reduce lung volume in emphysema is adequate in quantity and quality to support the use of this procedure provided that standard arrangements are in place for clinical governance, consent and audit.
Patient selection should be done by a multidisciplinary team experienced in managing emphysema, which should typically include a chest physician, a radiologist, a thoracic surgeon and a respiratory nurse.
Patients selected for treatment should have had pulmonary rehabilitation. The procedure should only be done to occlude volumes of the lung where there is no collateral ventilation, by clinicians with specific training in doing the procedure.
Wednesday, 20 December 2017
Admissions of inequality: emergency hospital use for children and young people
Does a child's socioeconomic background have an effect on rates of admissions to hospital for common conditions such as asthma, diabetes or epilepsy? Report from the Nuffield Trust.
NHS England announces new specialised treatments for patients
NHS England has announced the results of the first of two prioritisation rounds to decide which new specialised commissioning treatments and services will be made available for patients for the 2018/19 financial year.
An initial three new treatments and services were approved for funding including a treatment for HIV, a new specialised service for adults with primary ciliary dyskinesia, a genetic disorder affecting the respiratory system, and a new specialised service for Stevens-Johnson syndrome, a serious disorder of the skin.
Funding for the new treatments and services will begin from April.
Funding for the new treatments and services will begin from April.
Monday, 18 December 2017
Planning for seasonal demand in respiratory illness
Each winter, emergency departments experience a surge in respiratory attendances and emergency admissions for respiratory conditions double. It is therefore crucial to plan for this inevitable increase in demand so that patient flow is maintained.
A “quick guide” from NHS Improvement highlights ways to manage demand, including ambulatory emergency care, early supported discharge services, and urgent “hot” clinics. Use of these initiatives can reduce avoidable overnight admissions and improve patient flow and outcomes.
Local A&E delivery boards are advised to consider the recommendations as part of plans to manage the seasonal surge in respiratory admissions.
Local A&E delivery boards are advised to consider the recommendations as part of plans to manage the seasonal surge in respiratory admissions.
Friday, 15 December 2017
Pulmonary rehabilitation associated with lower hospital admission rates
The Pulmonary rehabilitation: Beyond breathing better report from the Royal College of Physicians (RCP) National Chronic Obstructive Pulmonary Disease (COPD) Audit Programme reveals that people who complete a full pulmonary rehabilitation programme are much less likely to be admitted to hospital than those who do not.
Wednesday, 13 December 2017
Benralizumab for Chronic Obstructive Pulmonary Disease (COPD)
Benralizumab is a new drug being developed for the treatment of chronic obstructive pulmonary disease. It is administered by injection under the skin and acts by targeting specific proteins that
causes the airway to narrow. If benralizumab is licensed for use in the UK, it could be a new treatment option for patients with chronic obstructive pulmonary disease that may improve quality of life and reduce the number of exacerbations.
From the NIHR Innovation Observatory
causes the airway to narrow. If benralizumab is licensed for use in the UK, it could be a new treatment option for patients with chronic obstructive pulmonary disease that may improve quality of life and reduce the number of exacerbations.
From the NIHR Innovation Observatory
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