What's New in Guidelines

Nemolizumab is recommended by NICE for adults with moderate to severe prurigo nodularis who have inadequate response to topical treatments or systemic corticosteroids, enabling earlier access to effective biologic therapy before exhausting conventional options…

Durvalumab combined with platinum-based chemotherapy is the recommended first-line treatment for untreated advanced or recurrent endometrial cancer, with olaparib addition considered based on individual patient factors and trial data. Assess patient eligibility carefully before…

Test for MSI-H/dMMR before treatment: All patients with advanced or recurrent endometrial cancer should undergo microsatellite instability or mismatch repair deficiency testing prior to dostarlimab consideration, as eligibility depends on confirmed MSI-H or dMMR…

Evaluation terminated: Brensocatib for non-CF bronchiectasis is no longer under NICE appraisal—do not initiate new treatment pathways for this indication pending alternative guidance from your local formulary or commissioning team. Age consideration: Any prior…

Evaluation terminated – Rilzabrutinib for immune thrombocytopenia (ITP) is no longer under NICE appraisal; refer to current NICE guidance or your local ITP treatment pathway for approved options Check current formularies – Do not…

This NICE evaluation was terminated, meaning lisocabtagene maraleucel is not currently recommended for routine NHS use in relapsed or refractory follicular lymphoma—do not commission or initiate treatment based on this technology appraisal. Patients with…

Consider ex-situ machine perfusion as an alternative to static cold storage for deceased donor livers, particularly for higher-risk grafts (extended criteria donors, prolonged cold ischaemia time) to potentially reduce primary non-function and early allograft…

Use acalabrutinib with venetoclax ± obinutuzumab as first-line treatment for untreated CLL – this combination is recommended by NICE and offers improved outcomes compared to standard chemotherapy, particularly in fit patients with del(17p) or…

First-line treatment option: Acalabrutinib combined with bendamustine and rituximab is recommended as a first-line treatment for untreated mantle cell lymphoma, offering an alternative to standard chemotherapy regimens. NICE-appraised intervention: This combination has undergone NICE…

Donidalorsen is recommended as a preventive treatment option for recurrent hereditary angioedema (HAE) attacks in patients aged 12 years and over – consider it when patients experience frequent symptomatic episodes despite current management, ensuring…

Finerenone is recommended as an option for chronic heart failure with preserved or mildly reduced ejection fraction (HFpEF/HFmrEF) and can be initiated in primary or secondary care following NICE criteria assessment Use finerenone alongside…

Refer boys with DMD to orthopaedic services early to prevent contractures and maintain mobility—early intervention with stretching, splinting, and positioning can delay loss of ambulation and reduce future surgical needs. Coordinate care between neuromuscular…

Patient selection: Consider aficamten for symptomatic obstructive hypertrophic cardiomyopathy patients who remain symptomatic despite optimised standard therapy (beta-blockers, non-dihydropyridine calcium channel blockers, or disopyramide), or who cannot tolerate these medications. Baseline assessment required: Obtain…

Use the FRAX tool or DXA scan results to stratify fracture risk in adults aged 50+ with risk factors (prior fracture, corticosteroid use, family history, low BMI, smoking, alcohol excess) rather than treating all…

Evaluation terminated – NICE discontinued appraisal of lutetium-177 vipivotide tetraxetan; this agent is not recommended for routine NHS use and should not be prescribed outside approved clinical trials or research programmes Patient selection criteria…

Netarsudil evaluation by NICE was terminated, indicating it is not recommended for routine use in NHS treatment pathways for open-angle glaucoma or ocular hypertension—continue using established first-line agents (prostaglandin analogues, beta-blockers, or carbonic anhydrase…

Deuruxolitinib is recommended as a treatment option for severe alopecia areata in adults—consider initiation in patients with extensive hair loss where conventional therapies have failed or are unsuitable Monitor patients on deuruxolitinib for infection…

Pembrolizumab combined with chemoradiotherapy is recommended for untreated locally advanced cervical cancer, improving survival outcomes compared to chemoradiotherapy alone—consider this combination as first-line treatment in eligible patients. Ensure baseline PD-L1 testing and assessment of…

Teplizumab is recommended for people aged 8 years and over with stage 2 type 1 diabetes to delay progression to stage 3; discuss with patients/families the realistic timescale for benefit and arrange specialist endocrinology…

First-line topical option: Glycopyrronium bromide cream is recommended as a first-line treatment for severe primary axillary hyperhidrosis in adults, offering an effective alternative to antiperspirants when standard treatments fail. Application and monitoring: Apply to…

Cemiplimab is recommended as a treatment option for patients with recurrent or metastatic cervical cancer only after progression on or following platinum-based chemotherapy—ensure prior chemotherapy failure is documented before considering this PD-L1 inhibitor. Assess…

Pirtobrutinib is recommended as a treatment option for relapsed or refractory chronic lymphocytic leukaemia (CLL) specifically in patients who have progressed on a prior BTK inhibitor, making it suitable for second-line BTK-directed therapy in…

Preoperative assessment: Systematically identify and optimise modifiable risk factors (cardiovascular, respiratory, renal function, anaemia, diabetes control) before elective surgery to reduce perioperative complications and length of stay. Venous thromboembolism (VTE) prophylaxis: Assess VTE risk…

Atogepant is recommended as a preventive treatment option for episodic migraine in adults; consider initiating in patients with ≥4 migraine days per month who have failed or are intolerant to other preventive agents Baseline…

Seladelpar is recommended as an option for adults with primary biliary cholangitis (PBC) who have had an inadequate response to ursodeoxycholic acid (UDCA) and have been previously treated with obeticholic acid (OCA)—consider as a…

Daratumumab in combination with bortezomib, lenalidomide and dexamethasone is recommended as a treatment option for newly diagnosed multiple myeloma patients who are ineligible for stem cell transplantation, offering improved outcomes compared to standard chemotherapy…

Mirvetuximab soravtansine is recommended for platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer in patients with folate receptor-alpha (FRα) positivity—confirm FRα status via appropriate testing before initiating treatment. This antibody-drug conjugate offers a…

Imlunestrant evaluation was terminated – NICE did not complete appraisal of imlunestrant for oestrogen receptor-positive HER2-negative advanced breast cancer; clinicians should refer to current NICE guidance on alternative endocrine therapies and CDK4/6 inhibitors for…

Serplulimab combined with carboplatin and etoposide is recommended as first-line treatment for untreated extensive-stage small-cell lung cancer (ES-SCLC) and should be considered for eligible patients as an alternative to chemotherapy alone Baseline PD-L1 expression…

Mepolizumab is recommended for patients with uncontrolled COPD and blood eosinophils ≥100 cells/μL; check eosinophil levels before initiating treatment as this is a mandatory eligibility criterion. Assess treatment response at 4 weeks and review…

First-line treatment option: Cemiplimab combined with platinum-based chemotherapy is recommended by NICE for patients with untreated advanced non-small-cell lung cancer (NSCLC), offering an evidence-based alternative to chemotherapy alone or other immunotherapy combinations. Patient selection…

Tisotumab vedotin is recommended for cervical cancer patients with recurrent or metastatic disease that has progressed despite prior systemic treatment—consider this as a treatment option when chemotherapy or other standard regimens have failed. Ensure…

Nogapendekin alfa inbakicept combined with BCG is no longer recommended for BCG-unresponsive non-muscle-invasive bladder cancer with carcinoma in situ in the UK, as NICE terminated its evaluation due to insufficient evidence of clinical benefit.…

Consider nusinersen or risdiplam early in SMA diagnosis – both are recommended treatment options for eligible patients and should be initiated promptly after confirmation, as early intervention improves outcomes in this progressive neuromuscular condition.…

Sotatercept is recommended as a treatment option for pulmonary arterial hypertension (PAH) in patients who meet NICE criteria; verify patient eligibility and existing PAH therapy status before initiating treatment. Consider sotatercept for PAH patients…

Durvalumab combined with chemotherapy should be offered as neoadjuvant treatment followed by surgery, then adjuvant durvalumab monotherapy for eligible patients with resectable gastric or gastro-oesophageal junction adenocarcinoma Ensure baseline assessment includes adequate performance status…