Should not routinely used for primary prevention of cardiovascular disease.

Enteric coated aspirin should not be used as it has a poor cost:benefit ratio. There is no convincing evidence that it reduces gastrointestinal bleeding (Drug Ther Bulletin, Jan 1997, p.7-8) and it has a lower bioavailability vs dispersable.

Gastroprotection with lansoprazole is advised.

Aspirin has multiple indications, follow the links below for more information

Unstable angina and NSTEMI guidelines

http://www.nice.org.uk/guidance/CG94

Stroke guidelines

http://www.nice.org.uk/Guidance/CG68

STEMI guidelines

http://www.nice.org.uk/guidance/CG167

AF guidelines

http://www.nice.org.uk/guidance/cg180

Hypertension in pregnancy guidelines

http://www.nice.org.uk/guidance/CG107

Akis brand of Diclofenac to replace Voltarol on the formulary, Akis does not require a buffer to dilute pior to administration

Only 250mg and 500mg of enteric coated formulation on formulary

Approved at NEL FPG in line with NICE TA 824.

Dexamethasone intravitreal implant (Ozurdex) is recommended as an option for treating visual impairment caused by diabetic macular oedema in adults only if their condition has not responded well enough to, or if they cannot have non-corticosteroid therapy.

This is an update and replacement of TA 349

• NICE TA 824

Approved at June 2021 DTC for Pericarditis (for 3 months treatment). To be initiated in hospital and continued by GP

Akis brand of Diclofenac to replace Voltarol on the formulary, Akis does not require a buffer to dilute pior to administration

Only 250mg and 500mg of enteric coated formulation on formulary

Approved at DTC March 2022 for the management of refractory idiopathic myopathies (adults and chidren aged 2 and over) as per NHSE commissioning policy (Hospital Only)

Abatacept for treatment of severe treatment-resistant morphoea (localised scleroderma) (adults and children 2 years and over) (210505P) [1921]

Approved in October 2021 DTC- as per NHSE commissioning policy statement (Hospital Only)

Approved in April 2022 DTC as per NHSE commissioning policy SSC2301.

IBD Shared Care Guidelines

• IBD Shared care guidelines Final Version.docx

Approved at April 2021 DTC - Baricitinib oral tablets for atopic dermatitis

https://www.nice.org.uk/guidance/ta574

Verkazia® (ciclosporin) 1 mg/mL eye drops approved at NEL FPG for  

• Severe Vernal Keratoconjunctivitis (VKC)  

Off-label indications:  

• Severe Atopic Keratoconjunctivitis (AKC),  

• Blepharo-keratoconjunctivitis (BKC) / Ocular Rosacea, 

• Thygeson’s keratitis & Chronic GvHD 

• Dry Eye Disease (DED)/ Keratoconjunctivitis Sicca (KCS) 

Formulary Status: Amber - Specialist initiated 

Akis brand of Diclofenac to replace Voltarol on the formulary, Akis does not require a buffer to dilute pior to administration

Approved at May 2021 DTC for moderate to severe rheumatoid arthritis in line with NICE TA676

Approved at July 2022 DTC for moderately to severely active ulcerative colitis in line with NICE TA792

• NICE TA 792

Guselkumab approved alone or with methotrexate, is recommended as an option for treating active psoriatic arthritis in adults whose disease has not responded well enough to disease-modifying antirheumatic drugs (DMARDs) or who cannot tolerate them. It is recommended only if they have had 2 conventional DMARDs and:
• have had at least 1 biological DMARD, or
• tumour necrosis factor (TNF)-alpha inhibitors are contraindicated but would otherwise be considered (as described in NICE's technology appraisal guidance on etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis).

• NICE TA 815

Approved for the treatment of active psoriatic arthritis after inadequate response to DMARDs as per NICE TA 711

September 2021 DTC

The committee Approved the anti-TNFs onto the Barts Health Formulary, in accordance with NICE TA715.

Infliximab S/C in patients with IBD approved via chairs action on January 2021.

Approved for treating axial spondyloarthritis as per NICE TA 718. Hospital Only. October 2021 DTC.

Only 250mg and 500mg of enteric coated formulation on formulary

Risankizumab approved at NEL FPG for treating moderately to severely active ulcerative colitis in line with NICE TA

Formulary Status: Hospital Only

• NICE TA 998

Approved via Chair's action 16th August 2022 for treating actice psoriatic arthritis in line with NICE TA803

Hospital Only

NEL FPG Approved for use in Connective Tissue Disease- Interstitial Lung Disease (CTD-ILD) and Hypersensitivity Pneumonitis- Interstitial Lung Disease (HP-ILD)

Treatment of Interstitial Lung Disease (ILD) in patients with severe active disease that has failed to respond to, or patient is intolerant to at least 2 immunosuppressants (tacrolimus, methotrexate, mycophenolate or cyclophosphamide), each having been taken for at least 3 months.

Rituximab IV 1g on day 1 and day 15, then repeated 6 monthly if the patient responds.

Hospital Only

On Formulary for Idiopathic Membraneous Glomerulonephritis,

biopsy-proven, steroid-sensitive minimal change nephropathy or primary focal segmental glomerulosclerosis (non-commissioned).

Renal Transplant Patients

For vasculitis in renal transplant 
As immunuppression for ABO incompatible transplants

Rituximab for the treatment of IgM paraproteinaemic demyelinating peripheral neuropathy in adults approved for use in May 2022 DTC as per Clinical Commissioning policy SSC2319

Secukinumab approved at NEL FPG for treating moderate to severe hidradenitis suppurativa in line with NICE TA

Hospital Only

• NICE TA 935

Approved at NEL-FPG in April 2023. Discount scheme applies until 2025. Commisioned by the ICB after this point as per the NEL High Cost Drug Pathway for Psoriasis 

Dose increased from 300mg once a month to 300mg fortnightly with a body weight of 90kg or higher. Patients who have an inadequate response after 3 months of dose escalation should be offered alternative treatment as per the NEL Psoriasis Pathway

Tofacitinib approved at NEL FPG for treating active ankylosing spondylitis in line with NICE TA.

Hospital Only

• NICE TA 920

 Upadacitnib approved at NEL FPG for previously treated moderately to severely active Crohn’s disease in line with NICE TA.

• NICE TA 905

Upadacitinib approved at NEL FPG (March 23) for treating moderately to severely active ulcerative colitis in line with NICE TA 856,

• NICE TA 856

Upadacitinib approved as an option for treating active ankylosing spondylitis that is not controlled well enough with conventional therapy in adults, only if tumour necrosis factor (TNF)-alpha inhibitors are not suitable or do not control the condition well enough.

• NICE TA 829

Approved at NEL FPG for treating active non-radiographic axial spondyloarthritis.

• NICE TA 861

Ustekinumab approved at NEL FPG for dose escalation in psoriasis.

Commissioned by the ICB under High Cost Drugs Pathway for Psoriasis 

• Patients ≤ 100 kg - Ustekinumab 45 mg SC every 12 weeks (licensed dose) may be increased to a maximum of 90 mg every 8 weeks

• Patients >100kg - Ustekinumab 90 mg every 12 weeks (licensed dose) may be increased to a maximum of 90 mg every 8 weeks

Shared Care Guidelines for Riluzole in motor neurone disease March 2020

• Riluzole in Motor Neurone Disease SCG.pdf

Hospital-Only Drug