NICE has updated its key therapeutic topic (KTT) document on medicines optimization priorities for type 2 diabetes with the latest efficacy and safety information.
The document supports NICE guidance on managing type 2 diabetes in adults, which was updated in July 2016. It reiterates key points from the guidelines, including the need to involve patients in decisions about their individual glycated hemoglobin targets, to reassess each patient’s specific needs at each consultation, and to optimize prescribing to take patient preference and comorbidities into account.
Glucose-lowering treatments
The publication highlights the NICE algorithm for selecting blood glucose therapy to support the latest guideline recommendations, and summarizes the latest data suggesting that glucose-lowering treatments could have cardiovascular (CV) benefits for patients with type 2 diabetes:
- In the LEADER trial, the glucagon-like-peptide-1 mimetic liraglutide reduced the risk for major adverse cardiovascular events (MACE; death from cardiovascular causes, nonfatal myocardial infarction and nonfatal stroke) among patients with CV disease or at high risk of developing it, and this reduction was driven primarily by a decrease in CV mortality risk.
- In the EMPA-REG OUTCOME study, adding the sodium glucose cotransporter 2 inhibitor empagliflozin to standard care reduced the risk for MACE among people with established CV disease through a reduction in CV death, but not myocardial infarction or stroke.
Prescribing data
The KTT document also provides updated data on prescribing trends in primary care, indicating that 49.7 million items were prescribed for diabetes in England in the 2015/2016 financial year at a net ingredient cost of £ 956.7 million. This translates to a 5.3% rise in the number of items and a 10.1% increase in cost from the previous financial year.
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