March 2022 • PharmaTimes Magazine • 8
// MEDICINE NEWS //
NICE has issued draft guidance recommending semaglutide to adults with one or more weight-related conditions and a body mass index (BMI) of at least 35kg/m2. The drug – also known as Wegovy – has also been recommended to people with a BMI of 30.0kg/m2 to 34.9kg/m2.
Thousands of people living with obesity are predicted to benefit from the drug, which has helped patients using it to reduce their weight by more than 10%. The STEP 1 clinical evaluation, a randomised double-blind trial, demonstrated that participants taking semaglutide lost on average 12% more of their body weight compared with placebo.
“We know that management of over weight and obesity is one of the biggest challenges our health service is facing with nearly two-thirds of adults either over weight or obese,” said Helen Knight, programme director in the centre for health technology evaluation at NICE. “It is a lifelong condition that needs medical intervention.”
Semaglutide can only be prescribed as part of a specialist weight management service with multidisciplinary input and for a maximum of two years, with patients able to inject themselves once a week with pens prefilled with semaglutide.
The drug works by suppressing appetite by mimicking a hormone which is released after eating, reducing overall calorie intake.
NICE has issued a Final Appraisal Document (FAD) recommending AstraZeneca’s Forxiga (dapagliflozin) within its marketing authorisation for the treatment of adults with chronic kidney disease (CKD). The FAD forms the basis of the final guidance that NICE issues to the NHS.
It is a decision that will give eligible patients access to the first treatment option indicated for CKD in nearly 20 years.
“I am thrilled by this decision from NICE, as this expanded recommendation is going to have a genuine impact on the way that kidney doctors and GPs can treat their patients,” said Professor James Burton, Professor of Renal Medicine and Honorary Consultant Nephrologist, University of Leicester.
CKD is a long-term condition, in which the kidneys do not function properly and are unable to remove waste products from the body. At advanced stages of the disease, this can result in tiredness, swollen ankles, feet and hands, shortness of breath and blood in the urine.
Approximately one in ten people are estimated to be affected by CKD in the UK, resulting in an estimated 40,000 to 45,000 premature deaths every year.
Meanwhile, around 1 million in England are estimated to be living with the condition undiagnosed. CKD accounts for a significant burden on the UK healthcare system, making up 1.3% of NHS spending.
A new survey by Kidney Cancer UK has revealed that two-fifths (40%) of patients are waiting over 84 days for a diagnosis, which is three times longer than NHS England’s Faster Diagnostic Standard (FDS).
This statistic has remained the same since 2019, despite the introduction of the FDS. The FDS states that the time from referral to diagnosis, or all clear, should be no more than 28 days. This suggests that kidney cancer patients are waiting up to 56 days for their doctor to decide whether to refer them for tests.
Kidney cancer is the seventh most common cancer in men and women in the UK, with 13 people dying of the condition every day. Kidney Cancer UK believes that misdiagnosis occurs in a quarter of cases and may be a key factor in the late diagnosis of the disease.
Over two-fifths (42%) of tumours reach stage three or four by the time they are diagnosed and a significant majority (83%) of patients are forced to have their whole kidney removed to treat the disease.
Nick Turkentine, CEO of Kidney Cancer UK, concluded: “We hope that our latest patient report findings will shine a light on the importance of early diagnosis, to both patients and medical professionals, so that survival rates improve.”
A European-wide research project has examined 31 pharmacy interventions on COVID-19 in 32 European countries. The comprehensive paper was published in Research in Social and Administrative Pharmacy and was co-led by Professor Zaheer-Ud-Din Babar, director of the Pharmaceutical Policy and Practice Research Centre at the University of Huddersfield.
The interventions include prevention, response and recovery measures. One of the recommendations outlines that a network of community pharmacies is needed in future national preparedness plans during public health emergencies, such as those presented by the COVID-19 pandemic.
These emergencies present a need for rapid responses to a massive population. The paper also covers improved access to medicines, expanded powers granted to pharmacies, rapid antigen testing and vaccination.
“By April 2020, there seemed to be few research studies detailing the interventions on COVID-19 provided by community pharmacists in Europe,” explained Professor Babar, “despite there being several news reports of relevant practice changes occurring almost every week which had emerged in early 2020 stemming from pharmacy associations.”
Although the research does not provide concrete guidance on practice and policymaking, Professor Babar believes the findings can pave the way for pharmacy associations to explore negotiations with governments for enhanced pharmacy roles in facilitating access to essential medication, medication usually supplied in hospitals, in point-of-care antigen-based test screening and emergency supply.