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NICE backs new treatment for cystic fibrosis

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A new treatment for cystic fibrosis patients with pseudomonas lung infections has been approved by NICE.

Draft recommendations from the health watchdog advised that tobramycin dry powder for inhaltion (Tobi Podhaler, Novartis) should be used as an option for treating such infections after data suggested it would be a cost effective use of NHS resources.

NICE said it was pleased to make the recommendation in a bid to combat respiratory failure resulting from chronic pulmonary infection caused by Pseudomonas aeruginosa, which is the primary cause of death in people with cystic fibrosis.

Tobramycin sodium dry powder for inhalation (DPI) works by decreasing the amount of bacteria in the lungs. Patients recommended to receive the treatment in order to improve or maintain lung function would inhale it through a breath-activated, hand-held device.

Although NICE noted limitations in the data analysed to assess the treatment options, it said tobramycin DPI was cheaper and slightly more effective than nebulised tobramycin.

The draft guidance set out by the health body recommends using tobramycin if the manufacturer provides it with the agreed discount and if nebulised tobramycin is considered an appropriate treatment, that is, when nebulised colistimethate is contraindicated, not tolerated or has not produced an adequate clinical response.

The health watchdog added that Colistimethate sodium dry powder for inhalation (Colobreathe, Forest Laboratories UK) is not recommended for treating chronic pulmonary infection caused by P. aeruginosa in people with cystic fibrosis. It said that patients currently using colistimethate sodium dry powder for inhalation (DPI) should be able to continue treatment until indicated to stop by their doctor.

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