Approved for Adult Onset Stills Disease.  Prior approval required.  Application to be submitted via Blueteq

Approved by JPG in 2013 for patients admitted with acute gout where the use of colchicine, NSAIDs and steroids was ineffective or contra-indicated.

The decision to initiate and prescribe Anakinra must be made by a consultant rheumatologist. Patients will receive one dose of 100mg by subcutaneous injection. If the symptoms are not sufficiently reduced after 24 hours the dose maybe repeated. No more than 2 doses should be administered for an attack.

Anakinra is not licensed for the management of gout. Patients should therefore be informed of this and educated about the use of Anakinra. Informed consent from the patient must be documented in the medical record.

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

Renal Transplant - HOSPITAL ONLY

• Kidney Transplantation in Patients with HIV Infection.pdf
• Drug chart template ATG HIGHRISK renal transplant recipient 2019.pdf
• Drug chart template BASILIXIMAB STANDARD RISK renal transplant recipient 2019.pdf
• Renal transplant immunosuppression protocol 2019 v2.2.pdf
• Renal transplant management of acute rejection guidelines v1.0.pdf

Approved NEL FPG in line with NICE TA 825.

Avacopan with a cyclophosphamide or rituximab regimen is recommended, within its marketing authorisation, as an option for treating severe active granulomatosis with polyangiitis or microscopic polyangiitis in adults.

• NICE TA 825

IBD Shared Care Guidelines

• IBD Shared care guidelines Final Version.docx

Renal Transplant - HOSPITAL ONLY

• Kidney Transplantation in Patients with HIV Infection.pdf
• Drug chart template ATG HIGHRISK renal transplant recipient 2019.pdf
• Drug chart template BASILIXIMAB STANDARD RISK renal transplant recipient 2019.pdf
• Renal transplant immunosuppression protocol 2019 v2.2.pdf
• Renal transplant management of acute rejection guidelines v1.0.pdf

Basiliximab was the only suitable alternative and so the Renal Unit planned to swap to this.  Daclizumab had been available at a reduced cost and so the change would result in a significant cost pressure for PCTs as these drugs were PbR exclusions. The Group ratified the change to basiliximab.

HOSPITAL ONLY

Immunosuppressive therapy for kidney transplant in adults (October 2017)

Belatacept is not recommended as an initial treatment to prevent organ rejection in adults having a kidney transplant. Patients whose treatment was started within the NHS before this guidance was published should have the option to continue treatment, without change to their funding arrangements, until they and their NHS clinician consider it appropriate to stop

HOSPITAL ONLY

120 mg vial IV

400 mg vial IV

Dose

10 mg/kg every 2 weeks for 3 doses then 10mg/kg every 4 weeks

200 mg prefilled pen / prefilled syringe

Dose

200 mg once weekly, administered subcutaneously.

Approved in line with NICE TA 752

• NICE TA 752

Refer to Parasitology section of MicroGuide.

Update of malaria prevention guidelines for travellers from the UK

• Malaria prevention guidelines for travellers from the UK

Renal Transplant - HOSPITAL ONLY

• Kidney Transplantation in Patients with HIV Infection.pdf
• Drug chart template ATG HIGHRISK renal transplant recipient 2019.pdf
• Drug chart template BASILIXIMAB STANDARD RISK renal transplant recipient 2019.pdf
• Renal transplant immunosuppression protocol 2019 v2.2.pdf
• Renal transplant management of acute rejection guidelines v1.0.pdf

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 

• Alopecia Pathway 03.pdf

• Dermatology high risk drugs monitoring sheet final.xls

To suppress the rheumatic process and in Systemic or Cutaneous Lupus Erythemetous

• Dermatology high risk drugs monitoring sheet final.xls

• Mycophenolate

Renal Transplant - HOSPITAL ONLY

• Kidney Transplantation in Patients with HIV Infection.pdf
• Drug chart template ATG HIGHRISK renal transplant recipient 2019.pdf
• Drug chart template BASILIXIMAB STANDARD RISK renal transplant recipient 2019.pdf
• Renal transplant immunosuppression protocol 2019 v2.2.pdf
• Renal transplant management of acute rejection guidelines v1.0.pdf

HOSPITAL ONLY FOR USE POST ORGAN TRANSPLANT

https://weshare.bartshealth.nhs.uk/immunology-immuno-haematology-and-general-haematology?media_item=18159&media_type=10#file-viewer

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

Truxima brand is used in clinical haematology indications. 

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

Topical is Sirolimus is available to use in patients with Tuberous Sclerosis Manifesting with Facial Angiofibromata.

• Dermatology high risk drugs monitoring sheet final.xls

Renal Transplant - HOSPITAL ONLY

• Kidney Transplantation in Patients with HIV Infection.pdf
• Drug chart template ATG HIGHRISK renal transplant recipient 2019.pdf
• Drug chart template BASILIXIMAB STANDARD RISK renal transplant recipient 2019.pdf
• Renal transplant immunosuppression protocol 2019 v2.2.pdf
• Renal transplant management of acute rejection guidelines v1.0.pdf

 Voclosporin with mycophenolate mofetil approved at NEL FPG for treating  lupus nephritis in line with NICE TA.

• NICE TA 882

HOSPITAL ONLY

See attached

• Alemtuzumab TICK BOX revised Sept 2014.doc

Approved to treat moderate to severe plaque psoriasis in line with NICE TA475.  Prior approval required via Blueteq

Approved at DTC July 2022 for for treating relapsing remitting multiple sclerosis as per NICE TA 794

• NICE TA 794

HOSPITAL ONLY

Multiple Sclerosis

Multiple Sclerosis

NICE TA32

• NICE TA32

HOSPITAL ONLY

NICE TA32

• NICE TA32

HOSPITAL ONLY

On Formulary Hospital Only

Ozanimod Approved at NEL FPG in line with NICE TA 828.

Ozanimod is recommended as an option for treating moderately to severely active ulcerative colitis in adults, only if:

• conventional treatment cannot be tolerated or is not working well enough and infliximab is not suitable, or

biological treatment cannot be tolerated or is not working well enough

• NICE TA 828

FOR HOSPITAL USE ONLY