News in brief: MBS item for MRI diagnosis of myocarditis; Dapagliflozin available on PBS for HFrEF; Global guidelines needed for thromboprophylaxis

Tuesday, 18 Jan 2022

MBS item for vaccine-related myocarditis MRI

A new MBS item is available from 1 January for cardiac MRI to assist in diagnosing myocarditis associated with mRNA COVID-19 vaccination.

The temporary item (63399) will be available for use from until July, and is intended for patients who have symptoms of myocarditis within 21 days of receiving the mRNA COVID-19 vaccines Comirnaty (Pfizer) and Spikevax (Moderna).

The item, with a schedule fee of $855.20, is for the investigation of myocarditis that cannot be definitively diagnosed using conventional imaging and other diagnostic tests such as echocardiogram, troponin; and chest X-ray.

The Department of Health says the temporary item is being made available “pending a full health technology assessment by the Medical Services Advisory Committee (MSAC) on the use of cardiac MRI in diagnosing myocarditis more broadly.”

Dapagliflozin available on PBS for HFrEF

The SGLT-2 inhibitor dapagliflozin (Forxiga) is listed on the PBS from 1 January 2022 for the treatment of symptomatic heart failure with reduced ejection fraction (HFrEF) in adults, as an adjunct to the standard of care therapy.

Reimbursement of the oral glucose lowering  therapy for heart failure is based on evidence of cardiorenal benefits beyond its current indication for glycaemic control in people with type 2 diabetes.

Cardiologist Professor Andrew Coats, Director of the Monash Warwick Alliance and Academic Vice-President, Monash and Warwick Universities, said the PBS listing of  dapagliflozin reflected the inclusion of additional treatment options for patients with HFrEF within the 2021 ESC clinical guidelines.

“We are seeing a global shift in the way we are managing heart failure. The much-awaited update to the clinical management of heart failure at a global level may catalyse an update in heart failure guidelines worldwide, including Australia, and may deliver the improved patient outcomes we need to see,” he said in a statement released on behalf of AstraZeneca Australia.

“I’m thrilled that there is now broader access to another treatment option that may help to reduce hospitalisation and improve symptom management,” he added.

Global guidelines needed for thromboprophylaxis

A group of international researchers is calling for global action on preventing hospital associated venous thromboembolism (VTE), alongside survey findings that revealed variation in national practices and guidelines.

According to the group, which included Professor Beverley Hunt, a Consultant Haematologist at Guys & St Thomas’ NHS Foundation Trust in London, UK, “it is essential to improve thromboprophylaxis adoption among hospitalised patients in order to meet WHO global targets of reducing mortality from non-communicable diseases by 25% by 2025”.

The call came with findings of a survey sent to members of the International Society on Thrombosis and Haemostasis (ISTH) designed to raise awareness of hospital associated VTE and explore different practices surrounding its risk assessment globally.

A total of 223 unique respondents from 213 unique hospitals and from 34 different countries responded to the survey, including 26 from Australia and NZ.

It revealed that on average 84% (n=179) of hospitals were reported as using a risk assessment tool, with 68% (n=121) having described it as mandatory. However, given that the data came from a sample of individuals with a major interest in thrombosis and haemostasis the results can’t be generalised, and the actual rates could be much lower, the researchers noted.

The findings also showed that just four (9%) of the countries surveyed – the UK, China, Belgium and North Macedonia – had national guidelines recommending use of VTE risk assessment.

“This data reinforces the concept that urgent measures are needed to improve the quality and use of risk assessment models to drive thromboprophylaxis around the globe,” the group concluded.

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