CCG briefing on Sacubitril Valsartan (Entresto®)

22 July 2016

Sacubitril valsartan is recommended as an option for treating symptomatic chronic heart failure with reduced ejection fraction, only in people:

with New York Heart Association (NYHA) class II to IV symptoms and
with a left ventricular ejection fraction of 35% or less and
who are already taking a stable dose of angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor-blockers (ARBs).

The attached briefing is designed to inform CCGs of the implications of NICE TAG 388 Sacubitril valsartan for treating symptomatic chronic heart failure with reduced ejection fraction.

Blood Glucose Testing and Implementation of ISO 2013 Accuracy Standards

27 June 2016

A new standard for accuracy of blood glucose testing meters and test strips will be coming into effect on 1st June 2016.

All blood glucose meters must conform to ISO 15197: 2013, and manufacturers will no longer be allowed to supply meters which do not meet these new standards after 31st May 2016.

MHRA information on TPP SystmOne and QRISK®2

15 June 2016

Following an investigation into the QRISK®2 Calculator in SystmOne run by TPP, code mapping errors were identified and as a precaution the tool was temporarily disabled. The MHRA have now confirmed that the problem has been fixed.

Orphenadrine 50mg tablets unavailable

10 June 2016

Disipal® (Orphenadrine) 50mg tablets have been discontinued and are no longer available. There is a generic version of Orphenadrine 50mg tablets but they are also currently unavailable due to a manufacturing problem (Not expected to be in stock before October 2016). We would advise all prescribers to review any patient currently prescribed orphenadrine.

Death Related to use of Fentanyl Patches

8 June 2016

Death related to use of fentanyl patches – reminder that exposure of the application site to external heat sources can increase absorption of the drug from the patch, resulting in increased plasma concentrations of fentanyl and buprenorphine and increased risk of opioid toxicity.

Vaccine Supply Update

MenC vaccine ordering reminder – programme ceases 1st July 2016.
Nimenrix – check expiry dates.
Primary infant vaccine – Infanrix IPV Hib available to order with no restriction on volume.

Updated PGDs: Measles Mumps and Rubella (MMR) Vaccine and Combined Low Dose Diphtheria, Tetanus and Inactivated Polio (Td/IPV) (Revaxis) Vaccine

The current Patient Group Directions for Measles Mumps and Rubella (MMR) Vaccine and Combined Low Dose Diphtheria, Tetanus and Inactivated Polio (Td/IPV) (Revaxis) Vaccine have been updated.

Updated PGDs: Boostrix-IPV/ Repevax, Pneumococcal Vaccines, Hib/MenC Vaccine

The current Patient Group Directions for Boostrix-IPV, Pneumococcal (PPV and PCV) and Hib/MenC have been updated.

Sacubitril valsartan (Entresto®) – Heart failure

NICE have recently published their advice on use of Sacubitril valsartan (Entresto®) for the treatment of symptomatic chronic heart failure with reduced ejection fraction.
Entresto® includes both a neprilysin inhibitor (sacubitril) and an angiotensin II receptor blocker (ARB; valsartan).
The complementary cardiovascular benefits of Entresto in heart failure patients are attributed to the enhancement of peptides that are degraded by neprilysin, such as natriuretic peptides (NP), by LBQ657 and the simultaneous inhibition of the effects of angiotensin II by valsartan.