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NICE approves drug to treat diabetic macular oedema

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Diabetic macular oedema (DMO) can now be treated with ranibizumab (Lucentis, Novartis) after the treatment was recommended by NICE.

The watchdog originally published guidance in November last year but after the manufacturer produced evidence of the drug effectively treating patients with DMO, NICE agreed to look at it again.

NICE now says ranibizumab should be considered as a potential treatment for people with DMO who have a central retinal thickness of 400 micrometres or more. The recommendation also relies on the manufacturer supplying the drug at a discounted price, as agreed when it submitted a revised patient access scheme earlier this year.

Anyone who might already be taking the drug with a thinner retina than stipulated in the guidelines will still be given it until the patient and medical professionals decide it would be better to end the treatment.

DMO occurs among diabetics who produce larger amounts of the protein vascular endothelial growth factor (VEGF). This, combined with less connective tissues around capillaries can cause plasma to escape from blood vessels in the retina, creating an oedema, which in turn can lead to serious loss of sight.

Ranibizumab is injected into the eye to try and block the creation of VEGF, which can then reduce the oedema.

Professor Carole Longson, health technology evaluation centre director at NICE said: “Our current guidance on the use of ranibizumab for treating visual impairment caused by diabetic macular oedema, published in November 2011, does not recommend the drug as an effective use of NHS resources.

“However, following the submission of a revised patient access scheme, we have conducted a rapid review of the original guidance. The manufacturer included updated analyses showing that ranibizumab could be expected to have a superior relative effect among people with central retinal thickness greater than 400 micrometres. This draft guidance recommending ranibizumab for some patients with diabetic macular oedema is now available for consultation.”

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