News in brief: Trikafta PBS listing still up in the air; New CRE guidance on COVID-19 in severe asthma; Little evidence to support GORD treatment in asthma

Trikafta PBS listing still up in the air

Advocacy groups for cystic fibrosis patients say they are lobbying behind the scenes to have Trikafta (elexacaftor/tezacaftor/ivacaftor) listed on the PBS after the Pharmaceutical Benefits Advisory Committee deferred a decision on a positive recommendation at its March meeting. Nettie Burke, CEO of Cystic Fibrosis Australia said the sticking point seemed to be the PBAC’s uncertainty over the cost effectiveness of Trikafta beyond 48 weeks of treatment. The group said it supported the PBAC suggestion of a Managed Access Program for Trikafta, which would normally cost $277,875.

“We expect people on Kalydeco, Orkambi and Symdeko over the age of 12 years will all move to Trikafta … Vertex and the PBAC need to agree what is a fair cost for new patients who have not previously had access to a modulator, those who stopped taking Orkambi and Symdeko but maybe able to tolerate Trikafta plus those who are transferring from Kalydeco, Orkambi and Symdeko,” she said in an update for patients.

New CRE guidance on COVID-19 in severe asthma

Updated clinical recommendation on COVID-19 and severe asthma have been released by the Centre of Excellence in Severe Asthma at the Hunter Medical Research Institute, Newcastle.

The latest recommendations include new information on community use and self-administration of some monoclonal antibody therapies such as dupilumab (Dupixent), which was not available when the initial guidelines were developed in 2020. New recommendations are also included on the role of oral corticosteroids in COVID-19, reflecting the latest recommendations from WHO on their benefits for severe and critical COVID-19.

Cochrane review finds little benefit in GORD treatment for asthma

A Cochrane Review has concluded that medical treatments for GORD have have a modest and uncertain effect on asthma in adults.

The systematic review conducted by Australian researchers drew on data from 23 studies of GORD treatment with 2872 participants. It found there was some evidence suggesting that medical treatment with proton pump inhibitors (PPIs), H2 receptor antagonists or prokinetics for GORD may result in reduced use of rescue medications and improved FEV₁ and morning PEFR. However the certainty of this evidence was moderate to low, and it was unlikely that the improvements seen on events such as asthma exacerbations, symptoms and doctor/hospital visits were clinically significant, the reviewers led by Dr Zoe Kopsaftis of the Respiratory Medicine Unit, The Queen Elizabeth Hospital, Adelaide said.

There was not enough evidence, with only two studies reporting on each, to assess surgical treatment or the effectiveness of GORD treatment in children, they added.

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