NICE publishes Guidance on Ablative Therapy for the Treatment of Barrett’s Oesophagus.
Full Text Here
Barrett’s oesophagus develops as a consequence of chronic gastro-oesophageal reflux disease. It is characterised by abnormal changes in the oesophageal lining that may, in some patients, become dysplastic and lead to oesophageal cancer. Oesophagectomy (surgical removal of the oesophagus) is the standard NHS treatment for high-grade dysplastic Barrett’s oesophagus or intramucosal cancer (including T1a); however, it is associated with significant mortality and morbidity. Consequently less invasive surgical techniques, such as endoscopic mucosal resection, and ablative treatments have been developed and are being used as alternatives for patients who are unsuitable for surgery or who express a preference for less invasive options. However, in the past there has been uncertainty whether ablative therapy for Barrett’s oesophagus is both clinically and cost effective compared with other management options.
Radiofrequency ablation is one of the ablative therapies currently being used. This has a standard depth of ablation that is set by the manufacturer. Photodynamic therapy has a greater depth of ablation than radiofrequency ablation, irrespective of the photosensitiser used (although only one photosensitiser (porfirmer sodium) is presently licensed in the UK). However greater depth of ablation is associated with higher rate of complications but clinicians do not control the depth and is dependent on the ablative therapy used.
Previously no evidence-based guideline has addressed the use of ablative therapies for the treatment of Barrett’s oesophagus in England and Wales, which may lead to variation in practice. This clinical guideline covers the use of ablative therapies (argon plasma coagulation, laser ablation, multipolar electrocoagulation, radiofrequency ablation and photodynamic therapy) and endoscopic mucosal resection compared with oesophageal surgery, and surveillance with proton-pump inhibitors for treating Barrett’s oesophagus with high-grade dysplasia or with early intramucosal cancer in adults (18 years and older) in secondary care.
For Market Access and Health Economics Service Click Here
Damien Bové is THE Drug Development and Regulatory Consultant (pharmaceutical or biotechnology), I work with my clients to define a drug development target, define a drug development strategy, define a regulatory strategy or define a commercial strategy. Our clients are generally raising funds or looking to license out their technology and we help them achieve it. If you want to know more don’t hesitate to get in touch.
Avoid Expensive Mistakes, Keep On Top of New and Changing Regulations for Free!
Sign up for the most value add free newsource you can get for free. We spend a huge amount of time and effort monitoring the main drug / device regulators websites for changes in the regulatory environment, and capture between 20 and 40 new regulations, rules and initiatives each month, and summaries them in a fantastic FREE monthly Regulatory and Market Round Up. You can Un-Subscribe at any time and we don not share your details with anybody. You can’t afford to miss out on this service. Just fill in the form below.
“Please note that the pages on this website are designed to provide you with general information only. We make no warranties, representations or undertakings about any of its content. This includes the completeness, accuracy and fitness for any particular purpose, or the content of any third party site referred to or accessed through it. You are personally responsible for ensuring that the information is correct and we will not be held liable or accountable for any mistakes that occur.”
