Consultations: DOAC statement and hypersalivation pathway

Two new consultations have been opened on the GMMMG site; see details below. Both consultations will run until 5pm on Monday 1st August 2022. Comments can be submitted using the feedback forms on the GMMMG consultations page, and comments are invited from all stakeholders.

DOAC statement

CRG seek comments from Greater Manchester on this position statement regarding the prescribing of best value direct oral anticoagulants (DOACs) for stroke prevention in atrial fibrillation. When developing the statement CRG carefully considered, amongst other things:

  • The financial savings associated with increased edoxaban use,
  • A clinician’s freedom to prescribe the treatment they think is most appropriate for their patient
  • The available evidence base to support (or not) the use of one medicine over another.
  • The Investment and Impact Fund indicators
  • The high court ruling that has invalidated the patent for apixaban, and may yet be subject to appeal.

CRG want edoxaban to be the first choice DOAC for use in non-valvular AF, and an alternative used where edoxaban would not be safe or appropriate. This position is still current at the time of publication of the draft statement, despite the legal issues surrounding apixaban.

GMMMG therefore seek feedback from a wide range of stakeholders regarding this statement.

Hypersalivation pathway

CRG seek comments from Greater Manchester on this draft pathway for the management of hypersalivation. It has been developed and approved by MFT and CRG are seeking to adapt it for use across GM, particularly in primary care.

It looks to provide evidence-based, cost-effective recommendations on the management of hypersalivation in a number of conditions.

GMMMG therefore seek feedback from a wide range of stakeholders regarding this pathway

Consultations: CRG actions and draft shared care protocol

Two new consultations have been opened on the GMMMG consultations page

CRG actions

On behalf of the GMMMG Clinical Reference Group, we now seek comments on the actions proposed at the April 2022 CRG meeting. Actions in this consultation include:

  • Simple eye ointment – DNP
  • Goserelin and leuprorelin for male early or advanced breast cancer – AMBER (see also consultation on updated draft shared care protocol)
  • Empagliflozin for chronic heart failure – GREEN following specialist advice
  • Dapagliflozin for chronic kidney disease – GREEN
  • Phenazone/lidocaine eardrops – add to formulary for treatment of otitis media
  • Pitolisant for excessive daytime sleepiness caused by obstructive sleep apnoea – DNP
  • Solriamfetol for excessive daytime sleepiness caused by obstructive sleep apnoea – DNP
  • Pegcetacoplan for paroxysmal nocturnal haemoglobinuria – RED
  • Atidarsagene autotemcel for metachromatic leukodystrophy – RED

Shared care protocol: GnRH analogues for breast cancer

CRG seek comments on this updated shared care protocol for the treatment of breast cancer.

The main changes are:

  • The addition of leuprorelin within the indications listed in the SCP
  • The SCP now includes the treatment of male breast cancer within the indications detailed in the SCP
  • A move to the new approved GM shared care protocol format.

Both consultations will run until 5pm on Wednesday 25th May 2022. Comments can be submitted using the feedback forms on the GMMMG consultations page, and comments are invited from all stakeholders.

Consultation: inclisiran information for primary care prescribers

A new consultation has been opened on the GMMMG consultations page on a draft information leaflet for inclisiran. 

The draft provides additional advice and information for prescribers, and is intended to support primary care prescribers and ensure a quality standard for the prescribing of inclisiran.

The consultation will be open until 5pm on Tuesday 3rd May 2022, and comments are invited from all stakeholders.

New consultations: high cost drugs pathways

Two new consultations have been opened on the GMMMG consultations page. The topics are:

  • High cost drugs pathway: psoriatic arthritis
  • High cost drugs pathway: axial spondyloarthritis

These consultations will be open until 5pm on Thursday 22nd March 2022, and comments are invited from all stakeholders.

GMMMG are mindful of additional service pressures at present therefore if you foresee any problems giving input on these consultations, or if you have any questions, please contact the secretariat at nuth.enquires.gmmmg@nhs.net.