Eczema (chronic) - alitretinoin: final appraisal determination (16th July 2009)
After considering the feedback from consultation, the Appraisal Committee has prepared a Final Appraisal Determination (FAD) on alitretinoin for the treatment of chronic eczema of the hand, refractory to steroids and submitted it to the Institute.
The FAD has been sent to the formal consultees for this appraisal who have 15 working days to consider whether they wish to appeal against it. Subject to any appeal by consultees, the FAD may be used as the basis for the Institute's guidance on the use of the appraised technology in the NHS in England and Wales.
The appraisal will close on 30th July 2009.
FAD
After considering the feedback from consultation, the Appraisal Committee has prepared a Final Appraisal Determination (FAD) on alitretinoin for the treatment of chronic eczema of the hand, refractory to steroids and submitted it to the Institute.
The FAD has been sent to the formal consultees for this appraisal who have 15 working days to consider whether they wish to appeal against it. Subject to any appeal by consultees, the FAD may be used as the basis for the Institute's guidance on the use of the appraised technology in the NHS in England and Wales.
The appraisal will close on 30th July 2009.
FAD
Guidance on when to suspect child maltreatment. Clinical Guidelines CG89 (22nd July 2009)
NICE has issued guidance to help healthcare professionals to identify children who may have been maltreated. The guidance provides a summary of alerting features that should prompt a healthcare professional to consider, suspect or exclude child maltreatment. Child maltreatment includes neglect, physical, sexual and emotional abuse, and fabricated or induced illness.
Guidance
Rituximab for first line chronic lymphocytic leukaemia. Technology Appraisal TA174 (22nd July 2009)
NICE has published guidance on the use of rituximab for the first line treatment of chronic lymphocytic leukaemia. The guidance recommends that rituximab should be considered as a possible first treatment for people with chronic lymphocytic leukaemia who are able to take fludarabine in combination with cyclophosphamide.
Guidance
Sinus tarsi implant insertion for mobile flatfoot. Interventional Procedure Guidance IPG305 (22nd July 2009)
Mobile flatfoot is a condition in which the foot becomes flattened when standing. It can occur in children, where it may self-correct, and in adults. It usually results from tendon damage. In most people this is asymptomatic, but in some it may cause pain or other symptoms. This procedure involves surgery to insert an implant just above the heel bone, with the aim of correcting the condition and improving symptoms.
Guidance
Prosthetic lumbar intervertebral disc replacement. Interventional Procedure Guidance IPG306 (22nd July 2009)
Artificial intervertebral discs have been developed to act as a functional prosthetic replacement unit for intervertebral units in much the same way as prostheses have been developed for a variety of joints such as the hip or knee. The design of most prosthetic discs is similar, with two metallic endplates separated by a more pliable inner core designed to emulate the biomechanical properties of the nucleus pulposus. The implantation of the prosthetic discs involves a small incision below the umbilicus. The diseased disc is partially or fully excised (depending on the prosthesis used). The vertebral endplates and surrounding spinal ligaments are preserved and help maintain implant stability. Single discs can be replaced, or alternatively, several levels can be replaced during the same surgery.
The standard intervention for patients with these indications would be discectomy and spinal fusion.
Guidance
Lung cancer (non-small-cell, second line) - gefitinib (terminated appraisal. Technology Appraisal TA175 (22nd July 2009)
NICE is unable to recommend the use in the NHS of gefitinib for the second-line treatment of locally advanced or metastatic non-small-cell lung cancer because no evidence submission was received from the manufacturer or sponsor of the technology.
Guidance
NICE has issued guidance to help healthcare professionals to identify children who may have been maltreated. The guidance provides a summary of alerting features that should prompt a healthcare professional to consider, suspect or exclude child maltreatment. Child maltreatment includes neglect, physical, sexual and emotional abuse, and fabricated or induced illness.
Guidance
Rituximab for first line chronic lymphocytic leukaemia. Technology Appraisal TA174 (22nd July 2009)
NICE has published guidance on the use of rituximab for the first line treatment of chronic lymphocytic leukaemia. The guidance recommends that rituximab should be considered as a possible first treatment for people with chronic lymphocytic leukaemia who are able to take fludarabine in combination with cyclophosphamide.
Guidance
Sinus tarsi implant insertion for mobile flatfoot. Interventional Procedure Guidance IPG305 (22nd July 2009)
Mobile flatfoot is a condition in which the foot becomes flattened when standing. It can occur in children, where it may self-correct, and in adults. It usually results from tendon damage. In most people this is asymptomatic, but in some it may cause pain or other symptoms. This procedure involves surgery to insert an implant just above the heel bone, with the aim of correcting the condition and improving symptoms.
Guidance
Prosthetic lumbar intervertebral disc replacement. Interventional Procedure Guidance IPG306 (22nd July 2009)
Artificial intervertebral discs have been developed to act as a functional prosthetic replacement unit for intervertebral units in much the same way as prostheses have been developed for a variety of joints such as the hip or knee. The design of most prosthetic discs is similar, with two metallic endplates separated by a more pliable inner core designed to emulate the biomechanical properties of the nucleus pulposus. The implantation of the prosthetic discs involves a small incision below the umbilicus. The diseased disc is partially or fully excised (depending on the prosthesis used). The vertebral endplates and surrounding spinal ligaments are preserved and help maintain implant stability. Single discs can be replaced, or alternatively, several levels can be replaced during the same surgery.
The standard intervention for patients with these indications would be discectomy and spinal fusion.
Guidance
Lung cancer (non-small-cell, second line) - gefitinib (terminated appraisal. Technology Appraisal TA175 (22nd July 2009)
NICE is unable to recommend the use in the NHS of gefitinib for the second-line treatment of locally advanced or metastatic non-small-cell lung cancer because no evidence submission was received from the manufacturer or sponsor of the technology.
Guidance
Tenofovir disoproxil fumarate for the treatment of hepatitis B. Technology Appraisal TA173 (22nd July 2009)
The National Institute for Health and Clinical Excellence (NICE) has today (22 July) published final guidance recommending the use of tenofovir disoproxil for the treatment of people with chronic HBeAg-positive or HBeAg-negative hepatitis B in whom antiviral treatment is indicated.
This guidance does not apply to people with chronic hepatitis B who also have hepatitis C, hepatitis D or HIV.
Guidance
Image-guided radiofrequency excision biopsy of breast lesions. Interventional Procedure Guidance IPG308 (22nd July 2009)
Breast lumps may need to be sampled to test for cancer. This minimally invasive procedure involves a small incision and insertion of a probe which uses radiofrequency energy to cut through the breast internally, aiming to remove the lump along with a small area of surrounding tissue to test for cancer.
Guidance
Intramuscular diaphragm stimulation for ventilator dependent chronic respiratory failure due to neurological disease. Interventional Procedure Guidance IPG307 (22nd July 2009)
Some patients with spinal cord injuries cannot breathe on their own and require a mechanical ventilator to assist them. Intramuscular diaphragm stimulation involves keyhole abdominal surgery (laparoscopy) to implant electrodes into the breathing muscle (diaphragm) close to its main nerve supply. Wires are connected through the skin to a battery-operated electrical stimulation system which causes the diaphragm to contract as it does in normal breathing. The aim of the procedure is to allow patients to breathe without mechanical assistance and to improve their quality of life.
Guidance
The National Institute for Health and Clinical Excellence (NICE) has today (22 July) published final guidance recommending the use of tenofovir disoproxil for the treatment of people with chronic HBeAg-positive or HBeAg-negative hepatitis B in whom antiviral treatment is indicated.
This guidance does not apply to people with chronic hepatitis B who also have hepatitis C, hepatitis D or HIV.
Guidance
Image-guided radiofrequency excision biopsy of breast lesions. Interventional Procedure Guidance IPG308 (22nd July 2009)
Breast lumps may need to be sampled to test for cancer. This minimally invasive procedure involves a small incision and insertion of a probe which uses radiofrequency energy to cut through the breast internally, aiming to remove the lump along with a small area of surrounding tissue to test for cancer.
Guidance
Intramuscular diaphragm stimulation for ventilator dependent chronic respiratory failure due to neurological disease. Interventional Procedure Guidance IPG307 (22nd July 2009)
Some patients with spinal cord injuries cannot breathe on their own and require a mechanical ventilator to assist them. Intramuscular diaphragm stimulation involves keyhole abdominal surgery (laparoscopy) to implant electrodes into the breathing muscle (diaphragm) close to its main nerve supply. Wires are connected through the skin to a battery-operated electrical stimulation system which causes the diaphragm to contract as it does in normal breathing. The aim of the procedure is to allow patients to breathe without mechanical assistance and to improve their quality of life.
Guidance
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