Nice | New treatments for BPH, MS and migraine

Sometimes NICE does technology appraisals and I always figure it's nice to know what's out there - even if we're not doing it ourselves, if for no other reason than that I know what to say when a patient appears with a Daily Mail cutting... So here are a few on common problems...

Prostatic urethral lift implants

This guideline advises that these can be used. Basically inserts which hold up the prostatic lobes are placed via the urethra. This then opens the urethra up. The big advantage is a reduction in the side-effects that commonly come with TURP, such as loss of sexual function. However the effects are not as long lasting, so it is likely to be used as a holding measure...

Teriflunomide for relapsing-remitting MS

This guideline is about Teriflunomide, which is otherwise known as Aubagio. Most current medications in MS are injectables, but this is an oral medication. It is immunomodulating and reduces disability at 3m after a relapse of MS. There is no difference at 6m. One important note is that it takes 2 yrs to clear from the system and is teratogenic, so women using it must be carefully counseled.

Transcranial Magnetic Stimulation (TMS) for migraine

This guideline advises that TMS can be used for both the treatment and prevention of migraine. It will be specialist led. There isn't much evidence of efficacy yet.

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