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The National Institute for Clinical Excellence (NICE) has announced its preliminary recommendations on the use of epoprostenol, iloprost, bosentan, sitaxentan and sildenafil for the treatment of pulmonary hypertension in adults.
The document on its website is for consultation only, and does not constitute NICE’s final guidance to the NHS.
But if the recommendations are implemented as they stand, they will significantly limit the prescribing options for the condition.
NICE said patients in advanced stages of primary pulmonary hypertension (PPH), which is a rare and incurable disease, will be “concerned” at the findings.
They indicate that people who can no longer control their symptoms with oral treatments will have no alternative disease-specific drug available to them on the NHS.
A NICE statement said: “In UK clinical practice, patients with PPH normally begin with symptomatic treatment alone.
“As the disease progresses, the patient will require disease-specific oral therapies and will eventually need a prostanoid in order to control the advancement of the disease and maintain quality of life.
“Prostanoids can be inhaled or given by intravenous infusion. The appraisal consultation document from NICE proposes that patients are to be denied access to prostanoid therapy and that other therapeutic choices are limited to one first-line oral therapy (sildenafil) and two alternative oral therapies (bosentan and sitaxentan), for patients in whom sildenafil is contraindicated or poorly tolerated.”
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