Fears over NICE PAH guidelines

Draft NICE guidelines on pulmonary arterial hypertension (PAH) have been criticised for restricting critically ill patients' access to treatment.

Under the proposed guidelines, treatments for advanced PAH will no longer be available to new patients. These include intravenous epoprostenol and inhaled iloprost.

The Pulmonary Hypertension Association has criticised this proposed restriction, saying it would compromise the treatment of new PAH patients, compared with present day practice.

Professor Andrew Peacock from the Scottish Pulmonary Vascular Disease Unit, said he was 'extremely disappointed' by the NICE draft guidelines.

'One of the drugs that we routinely use in the very sickest patients is epoprostenol. Without it, all we can offer these patients is palliative care.'

The proposed guidelines recommend sildenafil as first line treatment for PAH. If after three months there is no response to treatment, patients can be given bosentan or sitaxentan (GP, 7 March).

GPletters@haymarket.com

NICE PAH draft guidance

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