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(HealthNewsDigest.com) – LONDON, October 7, 2010 — The National Institute for Health and Clinical Excellence (NICE) has today announced new draft guidance which represents a significant step towards ensuring patients with Alzheimer’s disease in England and Wales receive treatment for their condition, from the early stages of disease.
New draft NICE guidance released today recommends that
acetylcholinesterase inhibitors, including Aricept(R) (donepezil), should be
made available to patients in England and Wales as options for managing mild
to moderate disease.[1]* This is a significant change to an earlier 2006 NICE
ruling which restricted access to these medicines for patients with moderate
disease only.
“This provisional decision by NICE is an important milestone for the
thousands of Alzheimer’s patients currently unable to receive treatment for
their condition. Early diagnosis and access to medication is critical to help
reduce both the short and long-term impact of this devastating condition on
patients, families and carers.” says Professor Roy Jones from The Research
Institute for the Care of Older People (RICE) Centre, Royal United Hospital,
Bath, UK
Today’s announcement is expected to be widely welcomed as it supports the
Department of Health’s National Dementia Strategy (NDS).[2] The NDS
encourages the active management of Alzheimer’s disease from its earlier
stages to minimise the burden of the condition on patients, their carers and
society. In addition, the need for greater access to dementia-specific
treatments is in line with the recent Alzheimer’s Disease International
report which calls for governments to make dementia a higher health priority,
to help tackle the huge burden of the disease.[3]
Nick Burgin, Managing Director UK, Eisai Limited (the manufacturer of
Aricept(R)) said: “We are delighted by NICE’s decision to again recommend
Alzheimer’s treatments such as Aricept(R) in the early stages of the disease.
This was the right decision for patients in 2000 when these medicines were
originally reviewed by NICE and it is the right decision today. While we
welcome this decision, it will always remain a huge disappointment that NICE
changed their original guidance in 2006, thereby preventing patients with
early stage Alzheimer’s disease from benefiting from early treatment. After a
five year battle, today’s recommendation will once again allow patients to
get the treatment they need, when they need it most.”
The draft NICE recommendations on Alzheimer’s disease treatment will now
go into consultation, with final guidance expected in early 2011.
*Additional information on the draft NICE guidance1
*Appraisal Committee’s preliminary recommendations
1.1 The three acetylcholinesterase (AChE) inhibitors (donepezil,
galantamine and rivastigmine) are recommended as options for managing mild to
moderate Alzheimer’s disease (as per their license indications), under all of
the following conditions:
– Only specialists in the care of patients with dementia
should initiate treatment.
– Treatment should be continued only when it is considered to
be having a worthwhile effect on cognitive, global, functional and
behavioural symptoms
– Patients who continue on the drug should be reviewed at
least every six months using cognitive, global, functional and
behavioural assessment.
– If prescribing an AChE inhibitor, treatment should normally
be started with a drug with the lowest acquisition cost (taking into
account required daily dose and the price per dose once shared care has
started). However, an alternative AChE inhibitor could be prescribed if
it is considered appropriate when taking into account adverse event
profile, expectations around adherence, medical comorbidity,
possibility of drug interactions and dosing profiles
1.2 Memantine is recommended within its licensed indication as
an option for managing Alzheimer’s disease for people with:
– Moderate Alzheimer’s disease who are intolerant of or have a
contraindication to AChE inhibitors or
– Severe Alzheimer’s disease
For the full guidance, please visit:
http://guidance.nice.org.uk/Type/TA/Published
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