Ezetimibe |
People with primary hypercholesterolaemia should be considered for exetimibe treatment in line with Ezetimibe |
for treating primary heterozygous-familial and non-familial hypercholesterolaemia as per NICE TA358 (replaces NICE |
TAG132) |
GREEN Ezetimibe tablets 10mg |
|
AMBER Bempedoic acid with ezetimibe [Nustendi®, Nilemdo®] |
This recommendation does not apply to bempedoic acid when used without ezetimibe. |
NICE TA694 Recommended as an option for treating primary hypercholesterolaemia (heterozygous familial and non-familial) |
or mixed dyslipidaemia as an adjunct to diet in adults. It is recommended only if: |
> statins are contraindicated or not tolerated. |
> ezetimibe alone does not control low-density lipoprotein cholesterol well enough, and |
> the company provides bempedoic acid and bempedoic acid with ezetimibe according to the |
commercial arrangement |
Bempedoic acid with ezetimibe can be used as separate tablets or a fixed-dose combination. |
Suitable for GP prescribing following recommendation/initiation by specialist. CCG commissioned |
Alirocumab (NICE TAG393) and Evolocumab (NICE TAG394) are recommended as options for treating primary |
hypercholesterolaemia or mixed dyslipidaemia |
|
RED Alirocumab (Praluent®) Solution for injection 75mg/mL, 150mg/ml (CCG commissioned) |
RED Evolocumab (Repatha®) |
GREEN RESTRICTED Inclisiran - see position statement CCG commissioned |
Supporting documents for practices: Inclisiran Prescribing information Leaflet |
Inclisiran_Summary information on the funding and supply-NHSE_v2-april-2023 |
Inclisiran dosing, administration, how to guide June 23 |
To be used in accordance with the 'Summary of National Guidance for Lipid Management for Primary and Secondary Prevention of CVD' |
See supporting documents for Inclisiran: |
Summary information on the funding and supply [NHSE] |
Prescribers Information Leaflet |
Dosing, administration, how to guide |
|
NICE TA733 Inclisiran is recommended as an option for treating primary hypercholesterolaemia (heterozygous familial and |
non-familial) or mixed dyslipidaemia as an adjunct to diet in adults. It is recommended only if: |
> there is a history of any of the following cardiovascular events: |
º acute coronary syndrome (such as myocardial infarction or unstable angina needing hospitalisation) |
º coronary or other arterial revascularisation procedures |
º coronary heart disease |
º ischaemic stroke or |
º peripheral arterial disease, and |
> low-density lipoprotein cholesterol (LDL-C) concentrations are persistently 2.6 mmol/l or more, despite |
maximum tolerated lipid-lowering therapy, that is: |
º maximum tolerated statins with or without other lipid-lowering therapies or, |
º other lipid-lowering therapies when statins are not tolerated or are contraindicated, and |
> the company provides inclisiran according to the commercial arrangement. |
|
GREEN Icosapent ethyl [Vazkepa] |
NICE TA805 Icosapent ethyl is recommended as an option for reducing the risk of cardiovascular events in adults. |
It is recommended if they have a high risk of cardiovascular events and raised fasting triglycerides (1.7 mmol/litre or |
above) and are taking statins, but only if they have: |
> established cardiovascular disease (secondary prevention), defined as a history of any of the following: |
- acute coronary syndrome (such as myocardial infarction or unstable angina needing hospitalisation) |
- coronary or other arterial revascularisation procedures |
- coronary heart disease |
- ischaemic stroke |
- peripheral arterial disease, and |
> low-density lipoprotein cholesterol (LDL‑C) levels above 1.04 mmol/litre and below or equal to 2.60 mmol/litre. |
See full NICE guidance ICB Commissioned |
|
Nicotinic acid group |
Do not offer nicotinic acid (niacin) for the prevention of CVD to any of the following: |
|
Omega-3-acid ethyl esters |
BLACK Omega-3-acid ethyl esters - Post Myocardial Infarction. |
NHS England has identified this product as an item that should not be routinely prescribed in primary care. Available to |
purchase over the counter. Click herefor the Position Statement for Omega-3-acid ethyl ester prescribing in CVD |
BLACK Omega-3 fatty acid compounds for preventing CVD |
NHS England has identified this product as an item that should not be routinely prescribed in primary care. Available to |
purchase over the counter. |
|
Recommendations in this section update and replace recommendations 1.10.4.1 and 1.10.4.2 from Type 2 diabetes |
(NICE clinical guideline 87). |
Do not offer omega‑3 fatty acid compounds for the prevention of CVD to any of the following: |
> people who are being treated for primary prevention | > people who are being treated for secondary prevention |
> people with CKD |
> people with type 1 diabetes |
> people with type 2 diabetes |
There is no evidence that omega‑3 fatty acid compounds help to prevent CVD |
|
Omega-3-acid ethyl esters - Hypertriglyceridaemia |
NHS England has identified this product as an item that should not be routinely prescribed in primary care. Available to |
purchase over the counter. |
BLACK Omega-3-acid ethyl ester capsules 1g. |
|
Anion-exchange resins |
Do not offer a bile acid sequestrant (anion exchange resin) for the prevention of CVD to any of the following: |
> people who are being treated for primary prevention |
> people who are being treated for secondary prevention |
> people with CKD |
> people with type 1 diabetes |
> people with type 2 diabetes |
|
Combination therapy for preventing CVD |
Do not offer the combination of a bile acid sequestrant (anion exchange resin), fibrate, nicotinic acid or omega-3 fatty acid |
compound with a statin for the primary or secondary prevention of CVD. |
|