The Pharmaceutical Journal Vol 267 No 7159 p139-143
4 August 2001

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NICE to look at cancer, depression and diabetes in new work list

New medicines to treat colorectal cancer and breast cancer, manic depressions and treatments for diabetes and kidney disease patients are to be considered by the National Institute for Clinical Excellence.

They form part of the sixth wave of topics which are being looked at by the institute, which is also to produce and update guidelines to help spread best practice and equal access to care throughout the health service in the identification of genetic risks of developing breast cancer. There will also be an appraisal of the use of home dialysis and guidance on the use of catheters for the intravenous feeding of ill neonates.

The medicines to be considered by the NICE are capecitabine (Xeloda) and tegafur uracil (Uftoral) for the two cancers, and a number of unspecified medicines which are currently being evaluated for use in bi-polar disorder (manic depression). The institute is also to attempt to achieve a consensus on the appropriate use of electroconvulsive therapy for depression, schizophrenia, mania and catatonia.

There will be three reviews related to the treatment of diabetes. The first will consider a model for patient education which has already shown promising results. The use of insulin glargine and other long-acting insulin analogues is to be reviewed, as is the role of insulin pump therapy for people with type 1 diabetes.

Other reviews will consider:

• immunosuppressive regimens for renal transplantation
• home versus hospital dialysis in end stage renal failure
• raloxifene and other selective oestrogen receptor modulators (SERMs) in the treatment of osteoporosis
• tension-free vaginal tape for stress incontinence
• thermal endometrial ablation for heavy menstrual bleeding
• new medicines to treat epilepsy
• anakinra for rheumatoid arthritis
• anti-virals in the prevention and treatment of influenza

Clinical guidelines and audit tools are to be produced in 13 treatment areas. They are:

1. cancers affecting children and adolescents
2. the genetic risk of familial breast cancer
3. the diagnosis and treatment of lung cancer
4. drug treatments and psychological therapies for anxiety and related common mental disorders
5. the short-term management of violent behaviour in psychiatric inpatients
6. patients who intentionally harm themselves
7. the assessment and prevention of falls in older people
8. continence
9. infertility services
10. routine antenatal care
11. parenteral nutrition in pre-term infants
12. epilepsy
13. chronic obstructive pulmonary disease

More details of the sixth work programme can be found on the NICE website at www.nice.org.uk.

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