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A list of completed technology appraisals from NICE

The following technology appraisals can be found on the NICE website, by following the links below.

Roll your mouse over the [+] symbol to reveal a brief summary of the guidance.

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No.   Title Issue Date Review Date
286 [+] Schizophrenia or bipolar disorder - loxapine inhalation [ID479] nhs accred May 2013 TBA
285 [+] Bevacizumab in combination with gemcitabine and carboplatin for treating the first recurrence of platinum-sensitive advanced ovarian cancer nhs accred May 2013 TBA
284 [+] Bevacizumab in combination with paclitaxel and carboplatin for first-line treatment of advanced ovarian cancer nhs accred May 2013 TBA
283 [+] Ranibizumab for treating visual impairment caused by macular oedema secondary to retinal vein occlusion nhs accred May 2013 TBA
282 [+] Pirfenidone for treating idiopathic pulmonary fibrosis nhs accred Apr 2013 TBA
281 [+] Canakinumab for treating gouty arthritis attacks and reducing the frequency of subsequent attacks (terminated appraisal) nhs accred Apr 2013 TBA
280 [+] Abatacept for the treatment of rheumatoid arthritis after the failure of conventional disease-modifying anti-rheumatic drugs (rapid review of TA234) nhs accred Apr 2013 TBA
279 [+] Percutaneous vertebroplasty and percutaneous balloon kyphoplasty for treating osteoporotic vertebral compression fractures nhs accred Apr 2013 TBA
278 [+] Omalizumab for treating severe persistent allergic asthma (review of technology appraisal guidance 133 and 201) nhs accred Apr 2013 TBA
277 [+] Methylnaltrexone for treating opioid-induced bowel dysfunction in people with advanced illness receiving palliative care (terminated appraisal) nhs accred Mar 2013 TBA
276 [+] Cystic fibrosis (pseudomonas lung infection) - colistimethate sodium and tobramycin [ID342] nhs accred Mar 2013 TBA
275 [+] Apixaban for preventing stroke and systemic embolism in people with nonvalvular atrial fibrillation nhs accred Feb 2013 TBA
274 [+] Ranibizumab for treating diabetic macular oedema (rapid review of technology appraisal guidance 237) nhs accred Feb 2013 TBA
273 [+] Tadalafil for the treatment of symptoms associated with benign prostatic hyperplasia (terminated appraisal) nhs accred Jan 2013 TBA
272 [+] Transitional cell carcinoma of the urothelial tract - vinflunine [ID320] nhs accred Jan 2013 TBA
271 [+] Diabetic macular oedema - fluocinolone acetonide intravitreal implant [ID419] nhs accred Jan 2013 TBA
270 [+] Leukaemia (acute myeloid ) - decitabine (terminated appraisal) nhs accred Dec 2012 TBA
269 [+] Melanoma (BRAF V600 mutation positive, unresectable metastatic) - vemurafenib [ID498] nhs accred Dec 2012 TBA
268 [+] Melanoma (stage III or IV) - ipilimumab [ID73] nhs accred Dec 2012 TBA
267 [+] Heart failure (chronic) - ivabradine [ID484] nhs accred Nov 2012 TBA
266 [+] Cystic fibrosis - mannitol [ID85] nhs accred Nov 2012 TBA
265 [+] Bone metastases from solid tumours - denosumab [ID81] nhs accred Oct 2012 TBA
264 [+] Stroke (acute, ischaemic) - alteplase (review of TA122) [ID536] nhs accred Sep 2012 TBA
263 [+] Bevacizumab in combination with capecitabine for the first-line treatment of metastatic breast cancer nhs accred Aug 2012 TBA
262 [+] Ulcerative colitis (moderate to severe, second line) - adalimumab (terminated appraisal) (TA262) nhs accred Jul 2012 TBA

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NICE is unable to recommend the use in the NHS of loxapine inhalation for treating acute agitation and disturbed behaviours associated with schizophrenia and bipolar disorder because no evidence submission was received from the manufacturer of the technology.

Bevacizumab in combination with gemcitabine and carboplatin is not recommended within its marketing authorisation, that is, for treating people with the first recurrence of platinum-sensitive advanced ovarian cancer (including fallopian tube and primary peritoneal cancer) who have not received prior therapy with bevacizumab or other vascular endothelial growth factor (VEGF) inhibitors or VEGF receptor-targeted agents.

People currently receiving bevacizumab in combination with gemcitabine and carboplatin for treating the first recurrence of platinum-sensitive advanced ovarian cancer should be able to continue treatment until they and their clinician consider it appropriate to stop.

Bevacizumab in combination with paclitaxel and carboplatin is not recommended for first-line treatment of advanced ovarian cancer (International Federation of Gynaecology and Obstetrics [FIGO] stages IIIB, IIIC and IV epithelial ovarian, fallopian tube or primary peritoneal cancer).

People currently receiving bevacizumab for first-line treatment of advanced ovarian cancer should be able to continue treatment until they and their clinicians consider it appropriate to stop.

1.1 Ranibizumab is recommended as an option for treating visual impairment caused by macular oedema:

  • following central retinal vein occlusion or
  • following branch retinal vein occlusion only if treatment with laser photocoagulation has not been beneficial, or when laser photocoagulation is not suitable because of the extent of macular haemorrhage and
  • only if the manufacturer provides ranibizumab with the discount agreed in the patient access scheme revised in the context of NICE technology appraisal guidance 274.
  • 1.2 People currently receiving ranibizumab whose disease does not meet the criteria in 1.1 should be able to continue treatment until they and their clinician consider it appropriate to stop.

    1.1 Pirfenidone is recommended as an option for treating idiopathic pulmonary fibrosis only if:

  • the person has a forced vital capacity (FVC) between 50% and 80% predicted and

  • the manufacturer provides pirfenidone with the discount agreed in the patient access scheme.
  • Treatment with pirfenidone that is recommended according to 1.1 should be discontinued if there is evidence of disease progression (a decline in per cent predicted FVC of 10% or more within any 12 month period).

    People currently receiving pirfenidone that is not recommended according to 1.1 should have the option to continue treatment until they and their clinician consider it appropriate to stop.

    NICE is unable to recommend the use in the NHS of canakinumab for treating gouty arthritis attacks and reducing the frequency of subsequent attacks because no evidence submission was received from the manufacturer of the technology.

    1.1 Abatacept in combination with methotrexate is recommended as an option for treating rheumatoid arthritis in adults whose disease has responded inadequately to 2 conventional disease-modifying anti-rheumatic drugs (DMARDs), including methotrexate, only if:

  • it is used in accordance with the recommendations for other biological DMARDs in Adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis (NICE technology appraisal guidance 130) and
  • the manufacturer provides abatacept with the discount agreed in the patient access scheme.
  • 1.2 People currently receiving abatacept whose disease does not meet the criteria in section 1.1 should be able to continue treatment until they and their clinician consider it appropriate to stop.

    1.1 Percutaneous verteboplasty, and percutaneous balloon kyphoplasty without stenting, are recommended as options for treating osteoporotic vertebral compression fractures only in people:

  • who have severe ongoing pain after a recent, unhealed vertebral fracture despite optimal pain management and
  • in whom the pain has been confirmed to be at the level of the fracture by physical examination and imaging.
  • 1.1 Omalizumab is recommended as an option for treating severe persistent confirmed allergic IgE-mediated asthma an add-on to optimised standard therapy in people aged 6 years and older:

  • who need continuous or frequent treatment with oral corticosteroids (defined as 4 or more courses in the previous year), and
  • only if the manufacturer makes omalizumab available with the discount agreed in the patient access scheme.

    1.2 Optimised standard therapy is defined as a full trial of and, if tolerated, documented compliance with inhaled high-dose corticosteroids, long-acting beta2 agonists, leukotriene receptor antagonists, theophyllines, oral corticosteroids, and smoking cessation if clinically appropriate.

    1.3 People currently receiving omalizumab whose disease does not meet the criteria in 1.1 should be able to continue treatment until they and their clinician consider it appropriate to stop.

  • NICE is unable to recommend the use in the NHS of methylnaltrexone for treating opioid-induced bowel dysfunction in people with advanced illness receiving palliative care because no evidence submission was received from the manufacturer of the technology.

    1.1 Tobramycin dry powder for inhalation (DPI) is recommended as an option for treating chronic pulmonary infection caused by Pseudomonas aeruginosa in people with cystic fibrosis only if:

  • nebulised tobramycin is considered an appropriate treatment, that is, when colistimethate sodium is contraindicated, is not tolerated or has not produced an adequate clinical response and
  • the manufacturer provides tobramycin DPI with the discount agreed as part of the patient access scheme to primary, secondary and tertiary care in the NHS.
  • Colistimethate sodium DPI is recommended as an option for treating chronic pulmonary infection caused by P.aeruginosa in people with cystic fibrosis only if:

  • they would clinically benefit from continued colistimethate sodium but do not tolerate it in its nebulised form and thus tobramycin therapy would otherwise be considered and
  • the manufacturer provides colistimethate sodium DPI with the discount agreed as part of the patient access scheme to primary, secondary and tertiary care in the NHS.
    • 1.2 People currently using tobramycin DPI or colistimethate sodium DPI that is not recommended according to 1.1 or 1.2 should be able to continue treatment until they and their clinician consider it appropriate to stop. For children and young people this decision should be made jointly by the clinician, the child or young person and their parents or carers.

    Apixaban is recommended as an option for preventing stroke and systemic embolism within its marketing authorisation, that is, in people with nonvalvular atrial fibrillation with 1 or more risk factors such as:

    • prior stroke or transient ischaemic attack
    • age 75 years or older
    • hypertension
    • diabetes mellitus
    • symptomatic heart failure.
    The decision about whether to start treatment with apixaban should be made after an informed discussion between the clinician and the person about the risks and benefits of apixaban compared with warfarin, dabigatran etexilate and rivaroxaban. For people who are taking warfarin, the potential risks and benefits of switching to apixaban should be considered in light of their level of international normalised ratio (INR) control.

    Ranibizumab is recommended as an option for treating visual impairment due to diabetic macular oedema only if:

    • the eye has a central retinal thickness of 400 micrometres or more at the start of treatment and
    • the manufacturer provides ranibizumab with the discount agreed in the patient access scheme (as revised in 2012).
    NICE is unable to recommend the use in the NHS of tadalafil for the treatment of symptoms associated with benign prostatic hyperplasia because no evidence submission was received from the manufacturer of the technology.

    Vinflunine is not recommended within its marketing authorisation for the treatment of advanced or metastatic transitional cell carcinoma of the urothelial tract that has progressed after treatment with platinum-based chemotherapy.

    People currently receiving vinflunine that is not recommended according to 1.1 should be able to continue treatment until they and their clinician consider it appropriate to stop.
    Fluocinolone acetonide intravitreal implant is not recommended for the treatment of chronic diabetic macular oedema considered insufficiently responsive to available therapies.

    NICE is unable to make a recommendation about the use in the NHS of decitabine for acute myeloid leukaemia because no evidence submission was received from the manufacturer of the technology.

    Vemurafenib is recommended as an option for treating BRAF V600 mutation-positive unresectable or metastatic melanoma only if the manufacturer provides vemurafenib with the discount agreed in the patient access scheme.

    Ipilimumab is recommended as an option for treating advanced (unresectable or metastatic) melanoma in people who have received prior therapy, only if the manufacturer provides ipilimumab with the discount agreed in the patient access scheme.

    Ivabradine is recommended as an option for treating chronic heart failure for people:

    • with New York Heart Association (NYHA) class II to IV stable chronic heart failure with systolic dysfunction and
    • who are in sinus rhythm with a heart rate of 75 beats per minute (bpm) or more
    • and who are given ivabradine in combination with standard therapy including beta-blocker therapy, angiotensin-converting enzyme (ACE) inhibitors and aldosterone antagonists, or when beta-blocker therapy is contraindicated or not tolerated
    • and with a left ventricular ejection fraction of 35% or less.

    Ivabradine should only be initiated after a stabilisation period of 4 weeks on optimised standard therapy with ACE inhibitors, beta-blockers and aldosterone antagonists.

    Ivabradine should be initiated by a heart failure specialist with access to a multidisciplinary heart failure team. Dose titration and monitoring should be carried out by a heart failure specialist, or in primary care by either a GP with a special interest in heart failure or a heart failure specialist nurse.

    Mannitol dry powder for inhalation is recommended as an option for treating cystic fibrosis in adults:

    • who cannot use rhDNase because of ineligibility, intolerance or inadequate response to rhDNase and
    • whose lung function is rapidly declining (forced expiratory volume in 1 second [FEV1] decline greater than 2% annually) and
    • for whom other osmotic agents are not considered appropriate.

    People currently receiving mannitol whose cystic fibrosis does not meet the criteria in 1.1 should be able to continue treatment until they and their clinician consider it appropriate to stop.

    Denosumab is recommended as an option for preventing skeletal-related events (pathological fracture, radiation to bone, spinal cord compression or surgery to bone) in adults with bone metastases from breast cancer and from solid tumours other than prostate if:

    • bisphosphonates would otherwise be prescribed and
    • the manufacturer provides denosumab with the discount agreed in the patient access scheme.

    Denosumab is not recommended for preventing skeletal-related events in adults with bone metastases from prostate cancer.

    Adults with bone metastases from solid tumours currently receiving denosumab for the prevention of skeletal-related events that is not recommended according to 1.1 and 1.2 should be able to continue treatment until they and their clinician consider it appropriate to stop.

    Alteplase is recommended within its marketing authorisation for treating acute ischaemic stroke in adults if:

    • treatment is started as early as possible within 4.5 hours of onset of stroke symptoms, and
    • intracranial haemorrhage has been excluded by appropriate imaging techniques.

    Bevacizumab in combination with capecitabine is not recommended within its marketing authorisation for the first-line treatment of metastatic breast cancer, that is, when treatment with other chemotherapy options including taxanes or anthracyclines is not considered appropriate, or when taxanes or anthracyclines have been used as part of adjuvant treatment within the past 12 months.

    People currently receiving bevacizumab in combination with capecitabine that is not recommended according to 1.1 should have the option to continue treatment until they and their clinician consider it appropriate to stop.

    NICE is unable to recommend the use in the NHS of adalimumab for the treatment of moderate to severe ulcerative colitis because no evidence submission was received from the manufacturer or sponsor of the technology.

    This appraisal relates to people whose disease has responded inadequately to conventional therapy including corticosteroids and mercaptopurine or azathioprine, or who are intolerant to or have medical contraindications for such therapies.