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Clarity’s DTG June 2022 Update

This update contains 10 significant changes and 7 minor changes.

Significant Changes

  • Benign paroxysmal positional vertigo – reviewed. A literature search was conducted in March 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.
  • Breast screening – reviewed. A literature search was conducted in April 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. No major changes to clinical recommendations have been made.
  • Candida – oral – reviewed. A literature search was conducted in April 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.
  • Croup – reviewed. A literature search was conducted in April 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.
  • Eczema – atopic – reviewed. An updated literature review was conducted in February 2022 to identify evidence-based guidelines, UK policy statements, systematic reviews, meta-analysis studies, and key randomized controlled trials published since the last full revision of this topic. Updated literature has been incorporated to provide supporting evidence for the guidance. A prescribing information section for topical calcineurin inhibitors has been added. Minor changes to prescribing advice in line with updated manufacturer guidance, and current recommendations in the British National Formulary. No major changes to the clinical recommendations have been made.
  • Headache – cluster – reviewed. A literature search was conducted in February 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. The recommendations have been updated in line with current evidence in the literature. The section on Prescribing information has been expanded to include detailed information about sumatriptan and zolmitriptan preparations for acute treatment of cluster headache.
  • Poisoning or overdose – reviewed. A literature search was conducted in March 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials (RCTs) published since the last revision of the topic.
  • Irritable bowel syndrome – reviewed. A literature search was conducted in March 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. Recommendations on the diagnosis and management of irritable bowel syndrome have been updated in line with guidance from the National Institute for Health and Care Excellence and the British Society of Gastroenterology.
  • Neck pain – non specific – reviewed. A literature search was conducted in April 2022 to identify evidence-based guidelines, UK policy, systematic reviews and key randomized controlled trials published since the last revision of the topic. Some minor changes have been made to recommendations in line with international clinical guidelines and published expert opinion.
  • Tinnitus – reviewed. A literature search was conducted in April 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic.

Minor Changes:

  • Contraception – combined hormonal methods – minor update. Angioedema added as an adverse effect in line with revised manufacturer’s SPC.
  • Diabetes – type 2 – minor update. Adverse effects and contraindications of metformin and SGLT-2 inhibitors updated in line with revised manufacturer’s SPCs.
  • GORD in children – minor update. The recommendation to consider ranitidine was changed to H2 receptor antagonists due to the global withdrawal of ranitidine. The prescribing information relating to omeprazole dosing was revised to include an update from the BNF and to remove the advice that this is a special preparation, as there are oral suspensions available on prescription.
  • Epilepsy – minor update. Relevant sections of this topic have been updated to align with the National Institute for Health and Care Excellence (NICE) guideline Epilepsies in children, young people and adults.
  • Fibroids – minor update. The recommendation for annual review in asymptomatic women has been removed based on a pragmatic approach to follow up instead for women who are symptomatic.
  • Insomnia – minor update. Removed reference to NICE key therapeutic topic as this has been withdrawn. Removed related adverse effects and updated these in line with the manufacturer’s summary of product characteristics.
  • Vitamin D deficiency in adults – minor update. Broken link replaced for advice on vitamin D preparations for people on a halal or kosher diet.