Cetuximab for the first line treatment of metastatic colorectal cancer - Technology Appraisal TA176 (26th August 2009)
Cetuximab given with other drugs called 5-fluorouracil, folinic acid and oxaliplatin is recommended as a possible first treatment for people with metastatic colorectal cancer only when:
Alitretinoin for the treatment of severe chronic hand eczema - Technology Appraisal TA177 (26th August 2009)
Alitretinoin is recommended as a possible treatment for people with severe chronic hand eczema if:
Extracorporeal shockwave therapy for refractory Achilles tendinopathy - Interventional Procedure Guidance IPG312 (26th August 2009)
Achilles tendinopathy is a condition of the tendon which connects the calf muscles to the heel bone. It is usually caused by overuse or injury. Symptoms include pain in the lower calf and back of the heel, and weakness or stiffness. In extracorporeal shockwave therapy, a machine is used to deliver sound waves to the painful area. It is not known exactly how it works, but it is thought that it might stimulate healing.
Guidance
Extracorporeal shockwave therapy for refractory plantar fasciitis - Interventional Procedure Guidance IPG311 (26th August 2009)
Plantar fasciitis is a painful condition affecting the connective tissue that stretches between the heel and the middle of the foot. It is usually caused by overuse, injury or muscular abnormalities. In extracorporeal shockwave therapy, a machine is used to deliver sound waves to the painful area. It is not known exactly how it works, but it is thought that it might stimulate healing of the fascia.
Guidance
Extracorporeal shockwave therapy for refractory tennis elbow - Interventional Procedure Guidance IPG313 (26th August 2009)
Tennis elbow is a condition affecting the tendons of the elbow which connect the muscles of the forearm to the upper arm bone. It may be associated with tiny tears in the fibres of the tendon and is usually caused by overuse or injury. Symptoms include pain in the outer part of the elbow, weakness or stiffness. In extracorporeal shockwave therapy, a machine is used to deliver sound waves to the painful area. It is not known exactly how it works, but it is thought that it might stimulate healing of the tendons.
Guidance
Percutaneous mitral valve leaflet repair for mitral regurgitation - Interventional Procedure Guidance IPG309 (26th August 2009)
Mitral regurgitation occurs when the mitral valve does not close properly, allowing blood to leak backwards. This can lead to shortness of breath and the heart may be unable to pump enough blood to the rest of the body. During percutaneous mitral valve leaflet repair, a catheter is inserted through the skin via a large vein in the groin or neck and passed through to the heart. The two leaflets of the mitral valve are partially clipped or sewn together to reduce the amount of blood leaking backwards.
Guidance
Placement of pectus bar for pectus excavatum (also known as MIRPE or the Nuss procedure) - Interventional Procedure Guidance IPG310 (26th August 2009)
Pectus excavatum is an abnormality of the chest in which the breastbone sinks inward (sometimes called funnel chest). Problems associated with pectus excavatum are mainly cosmetic, although the condition can impair cardiac and respiratory function. Placement of a pectus bar for pectus excavatum (also known as the Nuss procedure) involves placing one or two steel (pectus) bars under the breastbone with the aim of raising it and correcting the abnormal shape. The bar, which is bent into a curve to fit the patient’s chest, is inserted through small openings in the chest. The bar (or bars) are usually removed within a few years of placement.
Guidance
Bevacizumab (first-line), Sorafenib (first-and second-line), sunitinib (second-line) and temsirolimus (first-line) for the treatment of advanced and/or metastatic renal cell carcinoma - Technology Appraisal TA178 (26th August 2009)
Bevacizumab, sorafenib and temsirolimus are not recommended as first drug treatments for people with advanced and/or metastatic renal cell carcinoma.
Sorafenib and sunitinib are not recommended as second drug treatments for people with advanced and/or metastatic renal cell carcinoma.
Specialists should not stop prescribing bevacizumab, sorafenib, sunitinib and temsirolimus for people who were already taking them when the guidance was issued. These people should be able to carry on taking bevacizumab, sorafenib, sunitinib and temsirolimus until they and their specialists decide that it is the right time to stop treatment.
Guidance
Ultrasound-guided foam sclerotherapy for varicose veins - Interventional Procedure Guidance IPG314 (26th August 2009)
Varicose veins are veins that have become wider than normal and are unable to transport blood properly. Symptoms include heaviness, aching, throbbing, itching, cramps or fatigue in the legs. In severe cases, patients may have skin discolouration, inflammation, or skin ulcers. Foam sclerotherapy involves injecting a foam (which may either be a prepared product, or produced by mixing a chemical with air or other gas) into the affected vein. This inflames the vein and causes it to close Sometimes patients may need more than one injection to block the vein.
Guidance
Cetuximab given with other drugs called 5-fluorouracil, folinic acid and oxaliplatin is recommended as a possible first treatment for people with metastatic colorectal cancer only when:
- surgery to remove the cancer in the colon or rectum has been carried out or is possible
- the metastases are only in the liver and cannot be removed surgically before treatment
- the person is fit enough to have surgery to remove the cancer inthe colon or rectum and to have liver surgery if it becomes possible to remove the metastases after cetuximab treatment
- the manufacturer refunds 16% of the amount of cetuximab used on a per patient basis.
- surgery to remove the cancer in the colon or rectum has been carried out or is possible
- the metastases are only in the liver and cannot be removed surgically before treatment
- the person is fit enough to have surgery to remove the cancer in the colon or rectum and to have liver surgery if it becomes possible to remove the metastases after cetuximab treatment
- the person cannot take oxaliplatin because of its side effects or contraindications.
Alitretinoin for the treatment of severe chronic hand eczema - Technology Appraisal TA177 (26th August 2009)
Alitretinoin is recommended as a possible treatment for people with severe chronic hand eczema if:
- their eczema has not improved with treatments called potent topical corticosteroids and
- standard assessments show that their eczema is severe and is affecting their quality of life.
- as soon as the eczema has clearly improved or
- if the eczema remains severe after 12 weeks or
- if the eczema has not clearly improved after 24 weeks.
Extracorporeal shockwave therapy for refractory Achilles tendinopathy - Interventional Procedure Guidance IPG312 (26th August 2009)
Achilles tendinopathy is a condition of the tendon which connects the calf muscles to the heel bone. It is usually caused by overuse or injury. Symptoms include pain in the lower calf and back of the heel, and weakness or stiffness. In extracorporeal shockwave therapy, a machine is used to deliver sound waves to the painful area. It is not known exactly how it works, but it is thought that it might stimulate healing.
Guidance
Extracorporeal shockwave therapy for refractory plantar fasciitis - Interventional Procedure Guidance IPG311 (26th August 2009)
Plantar fasciitis is a painful condition affecting the connective tissue that stretches between the heel and the middle of the foot. It is usually caused by overuse, injury or muscular abnormalities. In extracorporeal shockwave therapy, a machine is used to deliver sound waves to the painful area. It is not known exactly how it works, but it is thought that it might stimulate healing of the fascia.
Guidance
Extracorporeal shockwave therapy for refractory tennis elbow - Interventional Procedure Guidance IPG313 (26th August 2009)
Tennis elbow is a condition affecting the tendons of the elbow which connect the muscles of the forearm to the upper arm bone. It may be associated with tiny tears in the fibres of the tendon and is usually caused by overuse or injury. Symptoms include pain in the outer part of the elbow, weakness or stiffness. In extracorporeal shockwave therapy, a machine is used to deliver sound waves to the painful area. It is not known exactly how it works, but it is thought that it might stimulate healing of the tendons.
Guidance
Percutaneous mitral valve leaflet repair for mitral regurgitation - Interventional Procedure Guidance IPG309 (26th August 2009)
Mitral regurgitation occurs when the mitral valve does not close properly, allowing blood to leak backwards. This can lead to shortness of breath and the heart may be unable to pump enough blood to the rest of the body. During percutaneous mitral valve leaflet repair, a catheter is inserted through the skin via a large vein in the groin or neck and passed through to the heart. The two leaflets of the mitral valve are partially clipped or sewn together to reduce the amount of blood leaking backwards.
Guidance
Placement of pectus bar for pectus excavatum (also known as MIRPE or the Nuss procedure) - Interventional Procedure Guidance IPG310 (26th August 2009)
Pectus excavatum is an abnormality of the chest in which the breastbone sinks inward (sometimes called funnel chest). Problems associated with pectus excavatum are mainly cosmetic, although the condition can impair cardiac and respiratory function. Placement of a pectus bar for pectus excavatum (also known as the Nuss procedure) involves placing one or two steel (pectus) bars under the breastbone with the aim of raising it and correcting the abnormal shape. The bar, which is bent into a curve to fit the patient’s chest, is inserted through small openings in the chest. The bar (or bars) are usually removed within a few years of placement.
Guidance
Bevacizumab (first-line), Sorafenib (first-and second-line), sunitinib (second-line) and temsirolimus (first-line) for the treatment of advanced and/or metastatic renal cell carcinoma - Technology Appraisal TA178 (26th August 2009)
Bevacizumab, sorafenib and temsirolimus are not recommended as first drug treatments for people with advanced and/or metastatic renal cell carcinoma.
Sorafenib and sunitinib are not recommended as second drug treatments for people with advanced and/or metastatic renal cell carcinoma.
Specialists should not stop prescribing bevacizumab, sorafenib, sunitinib and temsirolimus for people who were already taking them when the guidance was issued. These people should be able to carry on taking bevacizumab, sorafenib, sunitinib and temsirolimus until they and their specialists decide that it is the right time to stop treatment.
Guidance
Ultrasound-guided foam sclerotherapy for varicose veins - Interventional Procedure Guidance IPG314 (26th August 2009)
Varicose veins are veins that have become wider than normal and are unable to transport blood properly. Symptoms include heaviness, aching, throbbing, itching, cramps or fatigue in the legs. In severe cases, patients may have skin discolouration, inflammation, or skin ulcers. Foam sclerotherapy involves injecting a foam (which may either be a prepared product, or produced by mixing a chemical with air or other gas) into the affected vein. This inflames the vein and causes it to close Sometimes patients may need more than one injection to block the vein.
Guidance
No comments:
Post a Comment