Following a consultation period that began in February this year, the National Institute for Health and Clinical Excellence (NICE) has confirmed its radically revised guidance on hypertension treatment. Angiotensin-converting enzyme inhibitors are now recommended as first-line treatment for people under 55 years, while calcium antagonists and diuretics are advised as first-line treatment in the over-55s; beta-blockers are relegated to fourth-line therapy.
The original NICE guidelines were launched in August 2004 and directly contradicted the ‘ABCD’ treatment algorithm recommended by the British Hypertension Society (BHS). NICE and the BHS have now collaborated and agreed on the new guidance, ending nearly 2 years of prescribing confusion for GPs. A recent survey of over 200 GPs revealed the extent of the uncertainty, with 81% describing the discrepancies between guidelines as at least somewhat confusing.
‘Since August 2004, GPs have been in a quandary as to which guidance to follow,’ commented Dr Jonathan Morrell, GP, Hastings, East Sussex. ‘GPs will welcome a unified guidance that sets out clear, logical treatment steps to follow, which is based on a firm evidence base.’
Rimonabant 20mg receives marketing authorisation
Sanofi-Aventis announced on 28 June 2006 that the selective cannabinoid-1 receptor blocker Acomplia (rimonabant 20mg) has received marketing authorisation as an adjunct to diet and exercise for the treatment of obese people (body mass index [BMI] ≥30kg/m2) or for overweight people (BMI >27kg/m2) with associated risk factors such as type 2 diabetes or dyslipidaemia.
In clinical trials in overweight people, those who received rimonabant 20mg had significantly greater weight loss compared with placebo, and this was maintained at 2 years.
Device enhances blood circulation in lower extremities
FlowMedic’s FM220 Intermittent Compression System is a self-administered, portable, battery-operated device designed to enhance blood circulation in the lower extremities. It was demonstrated at The Diabetic Foot Journal Annual Conference and Exhibition in Edinburgh on 5–6 June 2006. Further studies are needed to see if long-term use of the device could improve walking distance in people with intermittent claudication.
NICE recommendation on Exubera criticised by Pfizer
Pfizer made a statement on 21 June 2006 that the new National Institute for Health and Clinical Excellence (NICE) recommendation on Exubera (inhaled insulin human) will force patients to prove mental illness in order to gain access to inhaled insulin.
Dr Olivier Brandicourt, Managing Director of Pfizer, commented that ‘Introducing a requirement to obtain a diagnosis of phobia from a psychiatrist will clearly discourage patients. The proposed approach will add the stigma of mental illness to the burden of diabetes.’
On 3 August 2006, Pfizer announced the UK launch of Exubera, which is currently the only available alternative to mealtime insulin injections.
Diabetes UK offers 300 free ‘talking blood glucose meters’
Diabetes UK is making 300 SensoCard Plus meters available to people on low incomes or in receipt of means-tested benefits. The meter helps people who are visually impaired by speaking the blood glucose level results.
The project is an extension of the Diabetes UK Samaritan Fund (SAM Fund), which provides ordinary blood glucose meters to those unable to purchase one themselves.
In addition, the initiative coincides with the re-launch of the SensoCard Plus meter by new distributors BBI Healthcare at a reduced cost. The Sensocard Plus meter cost £150 in 2005, when it was the first ‘talking blood glucose meter’ to become available in the UK. The device will now be available for £49.99.
Record levels of heart disease drug use seen in England
More drugs are being prescribed to reduce the risk of heart attacks and strokes than ever before, new figures from The Information Centre for health and social care reveal.
Latest prescribing data for England show a significant rise in the use of medicines to lower blood pressure and cholesterol over the past decade, reaching the highest ever level in 2005. Prescriptions for drugs to lower blood pressure more than quadrupled during the last 10 years.
Vinod Patel highlights the growing evidence base that lifestyle interventions are effective, and encourages persistence even though they can be difficult.
25 May 2023