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Agilio’s DTG November 2022 Update

This update contains 5 significant changes and 10 minor changes.

Significant Changes:

  • Measles — reviewed. A literature search was conducted in September-October 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key RCTs published since the last revision of this topic. No major changes to recommendations have been made.
  • Pruritis vulvae — reviewed. A literature search was conducted in September 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. No significant changes to recommendations were made.
  • Angio-oedema and anaphylaxis — reviewed. A literature search was conducted in September 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials (RCTs) published since the last revision of the topic. No major changes to recommendations have been made.
  • Herpes simplex – genital — reviewed. A literature search was conducted in August 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials (RCTs) published since the last revision of the topic. The recommendations have been updated in line with current evidence. The topic has undergone minor restructuring to improve clarity and navigation. A Prescribing information section has been added for oral antiviral drugs that may be used for episodic or suppressive therapy in primary care.
  • Dyspepsia – proven functional — reviewed. A literature search was conducted in September 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. No major changes to the recommendations have been made.

Minor Changes:

  • Heart failure – chronic — minor update. Added information about the use of empagliflozin for treating chronic heart failure with reduced ejection fraction.  Added a prescribing section on managing SGLT-2 inhibitors.
  • Conjunctivitis – infective — minor update. Links to some references were updated.
  • Attention deficit hyperactivity disorder — minor update. Adverse effects of dexamfetamine sulfate updated in line with manufacturer’s updated SPC.
  • Lyme Disease — minor update. Information that tick-borne encephalitis was detected in a small number of ticks in Thetford Forest and an area on the border between Hampshire and Dorset in 2019 has been added to this topic.
  • Angina — minor update. The text relating to contraindications and cautions for nitrates has been clarified.
  • Glaucoma — minor update. Additional information has been added to the section on adverse effects of topical prostaglandin analogues and prostamides.
  • Menopause — minor update. Information that exogenous oestrogens may induce or exacerbate symptoms of hereditary and acquired angioedema has been added to the adverse effects section of this topic.
  • Bipolar disorder — minor update. Information about a drug interaction between lithium and dapagliflozin has been added to this topic.
  • Osteoarthritis — minor update. The management recommendations have been updated in line the National Institute for Health and Care Excellence (NICE) clinical guideline Osteoarthritis in over 16s: diagnosis and management (2014). This includes advice on therapeutic exercise, offering pharmacological treatments alongside non-pharmacological treatments and at the lowest effective dose for the shortest possible time.
  • Alcohol – problem drinking — minor update. Replaced a link in the prescribing section for acamprosate relating to monitoring.