Berkshire West Area Prescribing Committee What was the APC asked to consider?

What priority should be given to the prescribing of modified release prednisolone (Lodotra®) for the treatment of rheumatoid arthritis?

Policy No:

APC 066

Date of Issue:

January 2014 January 2017 unless changes issued by NICE, TV Priorities Committee or significant new evidence available before this date.

Review Date:

Policy Statement: The NHS Berkshire West Area Prescribing Committee has reviewed the evidence for clinical and cost effectiveness of modified release prednisolone (Lodotra®). It considers the funding for treatment to be a LOW PRIORITY for the treatment of patients with rheumatoid arthritis. Key Points considered: - Lodotra® treatment does not have significant benefits over immediate release prednisolone. 28 days treatment with 5mg Lodotra® is more than 20 times the cost of uncoated IR prednisolone 5mg. - There are concerns over gastrointestinal safety. - Not considered to be cost effective.

References: 1. National Institute for Health and Clinical Excellence (2009). Rheumatoid Arthritis. National clinical guideline for management and treatment in adults. CG79. February 2009, London. Available online from: http://guidance.nice.org.uk/CG79. accessed 8/8/11 2. Electronic Medicines Compendium accessed via http://www.medicines.org.uk/EMC/medicine/23778/SPC/Lodotra+1+mg%2c+2+mg+and+5+mg+m odified-release+tablets/ 3. Nicola Greenhalgh South West Medicines Information, Bristol Royal Infirmary, Bristol, BS2 8HW. Prednisone Modified Release Tablets Produced for the UK Medicines Information Service accessed via http://www.nelm.nhs.uk/ on 8/8/11

Date taken to APC:

8th January 2014

Date Ratified by GP MOC on Behalf of the Board:

15th January 2014

Berkshire West Area Prescribing Policies serve as a guide to clinicians. This does not overrule the clinical or budgetary responsibility of clinicians when considering treatment for individual patients.