Regulatory Focus™ > News Articles > NICE Recommends Treatment for Eye Problem in Diabetics

NICE Recommends Treatment for Eye Problem in Diabetics

Posted 14 June 2013 | By Louise Zornoza

In draft guidance published today, the UK's National Institute for Health and Care Excellence (NICE) recommends Alimera's Iluvien for certain patients with chronic diabetic macular edema after the company offered a price cut for its treatment.

NICE is specifically recommending Iluvien, a fluocinolone acetonide intravitreal implant, in patients with chronic diabetic macular edema who are considered insufficiently responsive to other available therapies, as well as those who have had a natural lens replaced with an intraocular (pseudophakic) lens.

The macula is the central part of the retina responsible for seeing color and fine detail. Diabetic macular edema occurs as a result of changes in retinal blood vessels in people with diabetes. A reduction in the number of connective tissues around capillaries and an increased amount of a protein called vascular endothelial growth factor (VEGF) causes the blood retinal barrier to become more permeable.  This leads to leakage of plasma constituents in the surrounding retina, causing a build-up of excess fluid (edema) which disrupts the fovea, the area responsible for sharp vision. It can lead to severe visual impairment in the affected eye.

Chronic diabetic macular edema causes blurred or double vision and affects around 14% of people with diabetes in the UK. The Iluvien implant releases fluocinolone acetonide for up to 36 months, and has anti-inflammatory and anti-vascular endothelial growth factor (anti-VEGF) properties which can decrease the edema and limit visual loss and/or improve vision.

NICE had given the treatment a thumbs down in January, but reconsidered when Alimera cut the price of its product under a patient access scheme. Professor Carole Longson, health technology evaluation centre director at NICE, said: "Around 336,000 people with diabetes in the UK have diabetic macular edema. The condition can cause blurred or double vision in those affected. NICE is pleased to be able to recommend fluocinolone for some people for the treatment of this condition in draft guidance."

NICE Draft Guidance

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Tags: Diabetes, UK

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