NICE update: NICE adds treatment option for sialorrhoea

New technology appraisal TA605, Xeomin (botulinum neurotoxin type A) for treating chronic sialorrhoea, provides another treatment option for treating chronic sialorrhoea (drooling) caused by neurological conditions in adults, writes Gary Shield.

First-line treatment includes non-pharmacological treatment – bibs, speech and language therapy, occupational therapy and pharmacological treatments such as anticholinergics, of which glycopyrronium bromide is the most commonly used.

Clinical experts on the guidance committee highlighted a need for a targeted treatment such as Xeomin that avoids the side effects of anticholinergics. The mechanism of action of botulinum neurotoxin type-A products alter the production of saliva. This contrasts with current treatments, which can cause a dry mouth in a population who are likely to have swallowing difficulties.

About 34,000 people with chronic sialorrhoea are eligible for Xeomin, including those with Parkinson’s, cerebral palsy, traumatic brain injury, motor neurone disease, stroke and multiple sclerosis.

Meanwhile, TA606 Lanadelumab for preventing recurrent attacks of hereditary angioedema provides a further treatment option for a small population and is not expected to lead to a significant additional cost to implement.

Among the guidelines published recently, NG140 Abortion care covers care for women of any age (including girls and young women under 18) who request an abortion. It aims to improve the organisation of services and make them easier for women to access.

Detailed recommendations on conducting abortions at different gestational stages are also included, to ensure women get the safest, most effective care. Savings are anticipated as a result of minimising delays in abortion services, and a resource impact template allows users to model potential local savings by implementing the guideline.

• See the NICE website for guidelines and other resources

• Gary Shield is resource impact assessment manager at NICE