Welcome to this June issue of the Journal of Prescribing Practice. As prescribers, you know you need to stay up to date, look at guidance and keep an eye out for new medicines. Information about a new drug can come from many sources, and I came across one while browsing the BBC news website recently over my lunch break (BBC, 2024). Tafamidis (Vyndaqel, Pfizer) is the first drug for amyloidosis cardiomyopathy (ATTR-CM) that aims to treat the cause of the condition. Tafamidis slows the build-up of risky proteins in the heart muscle of people with ATTR-CM and could save lives; trials suggest it can cut death risk by about 41%. This rare condition typically starts to show in adulthood and gets worse over time as the heart tissue thickens and stiffens. The drug will be available from end of May 2024.
ATTR-CM symptoms include shortness of breath, palpitations and abnormal heart rhythms, ankle swelling, fatigue, fainting and chest pain. Ultimately, it can cause heart failure, so the advent of approval for this could be seen as very positive for sufferers. What it does mean is that healthcare practitioners who are dealing with this condition have a new drug to learn about and new guidelines to update themselves with before considering its prescription. The National Institute for Health and Care Excellence (NICE) is developing just such guidance, and it is expected to be published on 19 June 2024 (NICE, 2024). It anticipates this topic will be of importance to patients, carers and professionals as well as commissioners of services.
The drug is, of course, already listed in the British National Formulary (BNF, 2024), with the conditions it is licensed for clearly shown. It can also be found in the Electronic Medicines Compendium (2024), where we can see it was first authorised on 1 January 2021. The drug has been prescribable for another indication, and some information is known about interactions and side effects to help prescribers. If you are interested in this new drug, please see this month's research round-up, which focuses on its use in amyloid cardiomyopathy. It is worth remembering that, when moving to prescribe other drugs and extending or expanding your scope, there is advice available to you to assist with the process. Royal Pharmaceutical Society professional guidance (RPS, 2022) suggests you reflect, plan, act and then evaluate, and gives some helpful case studies for the user. The guidance is based around the familiar competency framework and can be used as part of your continuing professional development. It also provides a handy checklist to help you assess yourself against the framework. I feel this is a valuable document to all prescribers and can help them maintain their competence, inform their CPD, and prepare for revalidation as well as expand scope – so why not go and take a look?