Selected items from the News and Latest Additions sections of www.palliativedrugs.com, the world’s leading palliative care website.
Drug updates
NETAG does not recommend capsaicin cutaneous patch for neuropathic pain
The NHS North East Treatment Advisory Group (NETAG) does not recommend the use of capsaicin cutaneous patch (Qutenza) for neuropathic pain, the group were concerned about the clinical efficacy of the treatment and considered that it did not represent a cost-effective treatment option. More information is available in the decision summary and appraisal report.
NETAG does not recommend tolvaptan for hyponatraemia due to SIADH
Following an appeal, NETAG does not recommend the use of tolvaptan (Samsca) for hyponatraemia due to syndrome of inappropriate anti-diuretic hormone secretion (SIADH). The group concluded that tolvaptan is unlikely to be cost-effective compared with existing treatment options and was concerned about the potential for unrestricted long-term treatment. The group recognised that long-term treatment could be appropriate in certain circumstances according to a local protocol. For more information clink here.
Single dose fentanyl nasal spray launched in UK
NycoMed has launched Instanyl (fentanyl) single-dose nasal spray for the management of breakthrough pain in adults already receiving maintenance opioid therapy for chronic cancer pain. Instanyl single-dose nasal spray is available as a pack of 6 individual child-resistant blisters in 50, 100 and 200microgram strength all costing about £36 i.e. £6 per dose (NHS list price). The single dose blisters do not need priming before use. For more information see the SPC.
SMC rejects aprepitant
Following a resubmission, the Scottish Medicines Consortium (SMC) does not recommend the use of aprepitant (Emend), within NHS Scotland, as part of combination therapy for prevention of nausea and vomiting associated with moderately emetogenic cancer chemotherapy. The SMC concluded that the clinical and economic analyses submitted by the company were not sufficiently robust to gain its acceptance. For more information clink here.
Positive benefit-risk balance of pholcodine-containing cough medicines
The European Medicines Agency (EMA) has confirmed that the benefits of pholcodine-containing cough medicines outweigh their risks and that these medicines should remain available for the treatment of non-productive (dry) cough in children and adults.
A review was initiated following concerns that its use may put people at risk of developing anaphylactic reactions to neuromuscular blocking agents used during surgery. However the EMA Committee for Medicinal Products for Human Use (CHMP) found no firm evidence to substantiate the hypothesis. It also noted that pholcodine-containing medicines have been available for the treatment of non-productive cough in the EU for decades and existing data confirm a positive benefit-risk balance. For more information clink here.
EMA reject appeal for new indication for duloxetine
The CHMP of the EMA has confirmed its previous negative opinion on the application for a new indication for duloxetine (Cymbalta) for the treatment of moderate to severe chronic somatic pain in patients not taking NSAIDs regularly. For more information clink here.
Palonosetron capsules launched in UK
Palonosetron capsules (Aloxi, IS Pharmaceuticals) have been launched in the UK for the prevention of nausea and vomiting associated with moderately emetogenic cancer chemotherapy in adults. The dose is 500microgram administered approximately one hour before the start of chemotherapy. The cost of a 500microgram capsule is £56.
For more information see the SPC.
Prepared by Sarah Charlesworth and Andrew Wilcock