NICE decision on biologics "great news for ulcerative colitis patients"
The BSG has strongly welcomed NICE guidance issued today which approves the use of biologic drugs infliximab, adalimumab and golimumab for treating moderately to severely active ulcerative colitis (UC) after the failure of conventional therapy.
This follows consultation from NICE, to which the BSG and others responded strongly and expressed concern on behalf of UC patients at the potential withdrawal of a type of drug that has a proven stabilising impact on those suffering from UC and living with the chronic long-term effects of it.
Economic analysis in conjunction with partner organisations also demonstrates the cost benefits of these drugs to the economy.
There are known to be at least 300,000 patients with Inflammatory Bowel Disease in the UK, although the true figure is almost certainly much higher. The main conditions are Ulcerative Colitis and Crohn's Disease.
British Society of Gastroenterology Chair, Professor Chris Probert, said:
"This is great news for our patients with ulcerative colitis and the British Society of Gastroenterology strongly support this. NICE has listened to the specialists – clinicians and patients alike - and done the right thing. This is the first new class of drugs to be approved by NICE for UC and a valuable tool in the fight against UC. Hopefully most patients will not require such drugs but it is a great comfort to know that we can use them when we need to."
Changes in HCV therapy - approval of Sofosbuvir
Dr Stephen Ryder, BSG Vice-President Hepatology & Dr Andrew Austin, Chair BSG Liver Section
There are two major changes in HCV therapy which now have NICE and/or NHSE approval for use. The first is that commissioning guidance for the use of Simiprevir is published (http://www.england.nhs.uk/commissioning/spec-services/npc-crg/group-a/a02/). This allows G1 patients without Q80K to access triple therapy now using Simiprevir instead of Boceprevir or Telaprevir.
The second and probably more significant development is the approval of Sofosbuvir. The approval can be summarised as below:
Sofosbuvir in combination with pegylated interferon + ribavirin (Peg-IFN+RBV)
|HCV genotype||Adult patient population|
|Genotype 3||Treatment-naïve with cirrhosisa|
|Genotype 4, 5, or 6||Treatment-naïve & experienced with cirrhosisa|
Sofosbuvir in combination with RBV
|HCV genotype||Adult patient population|
|Genotype 3||Treatment-naïve with cirrhosisb|
|Treatment-experienced with cirrhosisb|
Cancer Genetics in Clinical Practice
A Guide to Cancer Genetics in Clinical Practice
BSG member Sue Clark has recently published a new textbook 'A GUIDE TO CANCER GENETICS IN CLINICAL PRACTICE' which has a significant gastroenterology content.
This book covers the basic concepts of cancer genetics. The common inherited cancer syndromes are each dealt with in greater depth, with the current management outlined. It is aimed at all clinicians who may encounter these conditions in their practice. The book sets out to facilitate identification of high-risk individuals and families, to inform interaction with geneticists and other sub-specialists, to provide a basis for patient management and to stimulate interest in these fascinating conditions.
View Flyer / Purchasing Details [ 38 Kb ]
Publication date: June 2009
BSG Guidance on Coeliac Disease 2010
The Management of Adults with Coeliac Disease
There is clear evidence that coeliac disease is a common gastrointestinal disease affecting up to 1% of the adult population. Individuals may go undetected for many years. This is despite multiple presentations to both primary and secondary care. This may reflect that fact that affected individuals have subtle gastrointestinal symptoms or no gastrointestinal symptoms.
An active case finding strategy will increase the number of patients detected with coeliac disease. Testing for coeliac disease should incorporate an IgA level, Tissue Transglutaminase antibody and/or Endomysial antibody (depending on what is locally available). In patients with a positive antibody a duodenal biopsy should be undertaken to confirm the presence of villous atrophy. In patients who are antibody negative but the clinician is suspicious then a duodenal biopsy should still be undertaken having ensured that the patient is not on a self-imposed gluten-free diet (GFD).
The cornerstone of treatment is a GFD. Patients require regular dietetic support with the opportunity or access to a gastroenterologist should further problems arise. Follow-up may be in primary or secondary care as long as the support is adequate (as noted previously).
In patients with persisting symptoms they should be investigated carefully with particular reference to ensuring that refractory coeliac disease is excluded.
BSG Response to White Paper: 'Healthy Lives, Healthy People'
Responses to Public Health White Paper: 'Healthy Lives, Healthy People: Our Strategy for Public Health in England'
Submitted 31st March 2011
- BSG Response [ 270 kb ]
The organisations that contributed to the joint response are:
- The British Association for the Study of the Liver
- The British Society of Gastroenterology
- The British Liver Trust
- The Hepatitis C Trust
- Alcohol Concern
- Joint Response [ 528 kb ]
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