Latest medicines assessed by SMC all accepted
Tigecycline (Tygacil) has been accepted for restricted use within NHS Scotland in the latest round of recommendations released by the Scottish
Medicines Consortium. The SMC has restricted the use of tigecycline to
second-line treatment of complicated intra-abdominal infection, and to
second- or third-line treatment of complicated skin and soft-tissue infections,
under the advice of local microbiologists or infectious disease specialists
(in both cases).
The SMC has also approved rosiglitazone/metformin (Avandamet) tablets
for use in combination with a sulphonylurea for patients (particularly
those who are overweight) who are unable to achieve sufficient glycaemic
control with dual oral therapy and are unable or unwilling to take insulin.
The SMC recommends that the “triple therapy” be initiated
and monitored by physicians experienced in treating diabetes patients.
Rosiglitazone/metformin was approved for use in type 2 diabetes by the
SMC last year (PJ, 15 January 2005, p40); the updated guidance is for
the additional triple therapy indication.
Cetuximab (Erbitux) has also been reviewed by the SMC and accepted for
use in Scotland in combination with radiation therapy for patients with
locally advanced squamous cell cancer of the head and neck. The SMC is
restricting cetuximab to use by head and neck cancer specialists for
patients who are cannot be treated with chemoradiotherapy and who are
without evidence of distant metastases.
Ropinirole — recently relaunched as Adartrel by GlaxoSmithKline
for the treatment of moderate to severe restless legs syndrome (PJ, 20
May, p588) — has been re-examined by the SMC and approved for the
new indication. The SMC says that ropinirole should be restricted to
use in patients with a baseline score of 24 points or more on the international
restless legs scale.
The following products have also been accepted by the SMC: dinoprostone
(Propess) 10mg vaginal delivery system — the new pessary formulation
which can remain in place for 24 hours (PJ, 24/31 December 2005, p771) — for
initiation of cervical ripening in patients at term (from 38 weeks of
gestation); testosterone gel (Testim) as replacement therapy for adult
male hypogonadism with testo-sterone deficiency confirmed by clinical
features and biochemical tests; and clobetasol propionate 0.05 per cent
cutaneous foam (Clarelux) for short-course treatment of steroid-responsive
dermatoses of the scalp, such as psoriasis, which do not respond satisfactorily
to less potent steroids. |
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