<a href="${link:{uuid:{55f30477-c7e2-49c0-8cfc-16966f28d4c2},repository:{dam},path:{/Portal/UK/Prescribing-links/Praluent-PI-GB-October-2022.pdf}}}" target="_blank">Prescribing Information(GB)</a>

<a href="${link:{uuid:{9e0d6f97-2ebb-4422-92ab-569b89c7dfe0},repository:{dam},path:{/Portal/UK/Prescribing-links/Praluent-PI-NI.pdf}}}" target="_blank">Prescribing Information(NI)</a>

Residual risk in the ACS patient and the contribution of cholesterol 
 Post-ACS patients may still be at high risk events despite current statin therapy1. Why is it important to do something differently?

Why use Praluent®&nbsp;in patients with ACS? 
 Odyssey Outcomes data demonstrates the benefit of further LDL-C lowering in the post-ACS population2. Why are these results relevant to cardiologists?

<a href="/uk/dyslipidaemia">SEE MORE FROM SCIENCE</a>

<h3>Praluent®</h3>
Find more information on Indication, Administration and Mechanism of Action and watch videos about Praluent®.

<h3>Patient Website</h3>
Find resources and support for your patients on Praluent®. Find useful links about how patients can manage their cholesterol.

<h2>Get in touch with the Dyslipidaemia Team</h2>

Praluent® (alirocumab) Prescribing Information (GB)

Praluent® (alirocumab) Prescribing Information (NI)

DYSLIPIDEMIA

CARDIOLOGY

A cardiologist's view - Professor Azfar Zaman

Welcome to the&nbsp;Better Care for Rare&nbsp;page, where we explore initiatives and projects aimed at improving the lives of those affected by rare lysosomal storage disorders.

Supporting Real-World Evidence Generation

Supporting the rare disease community

Fulfilling priorities in England Rare Disease Framework

Adopting big data &amp; artificial intelligence to advance diagnosis for rare diseases

BETTER-CARE-FOR-RARE

RARE-DISEASE

Better Care for Rare

<a href="${link:{uuid:{3c621072-b317-4715-bb3e-c63ceb933735},repository:{dam},path:{/Portal/UK/Prescribing-links/Dupixent-AD-and-PN-GB-PI.pdf}}}">DUPIXENT(dupilumab) Prescribing Information GB</a>

<a href="${link:{uuid:{24d957f3-a739-4a69-83e2-5be7f4b65bff},repository:{dam},path:{/Portal/UK/Prescribing-links/Dupixent-AD-and-PN-PI-IE-XI.pdf}}}" target="_blank">DUPIXENT (dupilumab) Prescribing Information NI/ROI</a>

<h2>What is Atopic Dermatitis</h2>
Atopic dermatitis (AD) is a chronic disease driven by persistent underlying inflammation even in nonlesional or normal looking skin 1-3&nbsp;
<ul>
 <li>Atopic dermatitis is an immunological disease where the immune system causes more inflammation than normal</li>
 <li>The overactive immune system under the surface may lead to increased inflammation on the surface and is a contributing factor to the itchy patches on the skin</li>
 <li>Moderate-to-severe AD in adults is a chronic, debilitating inflammatory condition that requires long-term control 1,4</li>
</ul>

<h2>Challenges of treating Atopic Dermatitis</h2>
Atopic dermatitis (AD) is a chronic disease driven by persistent underlying Type 2 inflammation 1-3&nbsp;
Even skin that appears non-lesional on the surface is clearly distinct from normal skin:1-3&nbsp;

Non-lesional skin in AD has been shown to have cutaneous expansion of T cells and abnormalities that are largely similar to lesional AD skin. This highlights the importance of early identification and treatment of patients with this condition.&nbsp;

ATOPIC-DERMATITIS

DERMATOLOGY

Tool to identify an uncontrolled AD patient&nbsp;

<ul>
 <li>In the UK, ciclosporin is the only conventional systemic immunosuppressant approved for the management of severe AD in adults5.&nbsp;Other systemic immunosuppressants are used off-label, despite limited evidence supporting their efficacy and safety6-8&nbsp;</li>
 <li>Systemic immunosuppressants exert broad suppression of the immune system, while immunomodulators target specific immune pathways/cell types, thereby reducing off-target effects9&nbsp;</li>
 <li>Broad-acting immunosuppressants are associated with a range of toxicities and side effects that limit their long-term use and require routine laboratory monitoring to minimise the risks 6,7,10,11</li>
</ul>
<h3>Watch Dr. Woolf discuss the impact of immunosuppressant cycling:&nbsp;&nbsp;</h3>

Read to learn more about Atopic Dermatitis and its underlying causes&nbsp;

An Introduction to Atopic Dermatitis

AD experts* proposed four types of treatment failure which patients with AD may experience despite appropriate dose, duration and adherence to a therapeutic agent12:&nbsp;
<ol>
 <li>Inadequate clinical improvement12&nbsp;</li>
 <li>Failure to achieve stable long-terms disease control12</li>
 <li>Adverse events or poor tolerability with current treatment12</li>
 <li>Failure to relieve burden of disease† 12</li>
</ol>

*A steering committee that consisted of a multi-disciplinary group of AD experts, including 8 dermatologists, two allergists and a patient advocacy group representative. This group met to identify and prioritise a number of essential questions concerning the evaluation and management of moderate-to-severe AD in the era of biologic therapies&nbsp;
†Presence of ongoing impairment (e.g., pruritus, pain, loss of sleep, and poor quality of life) while on treatment

<h2>The Role of Type 2 Inflammation&nbsp;</h2>
Dysregulated signaling of IL-4 and IL-13—two key drivers of type 2 inflammation—plays an important role in the pathogenesis of AD&nbsp; 13-18&nbsp;
IL-4 is a key upstream modulator of Th2 response, promoting a positive feedback loop that contributes to dysregulated secretion of IL-4, IL-13, and IL-31 #&nbsp;

IL-4 and IL-13 have overlapping roles in Type 2 inflammation:

<h3>Watch Dr Alan Irvine discuss the role of IL-4 in Type 2 Inflammation for more information&nbsp;&nbsp;</h3>

<h3>Management approaches in AD should address the persistent underlying Type 2 inflammation&nbsp;&nbsp;</h3>
<ul>
 <li>Three types of immune response play a natural protective role against different pathogens, the Type 2 immune response drives AD specifically 1-3&nbsp;</li>
 <li>Broad spectrum immunosuppressants do not specifically inhibit Type 2 inflammatory pathway&nbsp;19-21&nbsp;</li>
 <li>Non-specific mechanisms may result in unwanted side effects and the need for lab monitoring, limiting traditional systemic treatments as long-term therapeutic options 1,19-24&nbsp;</li>
</ul>

<h3>Watch this video to hear Dr Woolf discussing the immunological targets at play in AD:</h3>

<h3>DUPIXENT directly targets the underlying type 2 inflammation involved in AD.</h3>

Read to learn more about Atopic Dermatitis and its underlying causes 

DUPIXENT (dupilumab) Prescribing Information GB

DUPIXENT (dupilumab) Prescribing Information NI/ROI

This is intended for HCPs practising in Great Britain (England, Scotland and Wales) only.
<a href="${link:{uuid:{b396cd3c-8152-48f5-ae78-06924624d39e},repository:{dam},path:{/Portal/UK/Prescribing-links/Supemtek-PI-GB-April-2023.pdf}}}" target="_blank">Supemtek®</a>▼<a href="${link:{uuid:{b396cd3c-8152-48f5-ae78-06924624d39e},repository:{dam},path:{/Portal/UK/Prescribing-links/Supemtek-PI-GB-April-2023.pdf}}}" target="_blank">Quadrivalent Influenza Vaccine (recombinant, prepared in cell culture) Prescribing Information</a>
In October 2020, the European Centre for Disease Prevention and Control (ECDC) published the results of a systematic literature review to assess the efficacy, effectiveness and safety of enhanced inactivated flu vaccines (versus standard-dose or placebo) for the prevention of laboratory-confirmed influenza in adults ≥18 years of age.1
Only direct comparisons versus traditional vaccines were considered in the review as indirect comparisons were considered to be typically underpowered to detect differences in effect in this context.1

<h2>Methods of the ECDC systematic literature review</h2>
A systematic literature review of records published across MEDLINE, Embase, CINAHL and The Cochrane Library, up to 7 February 2020, was conducted. Randomised controlled trials and non-randomised studies of interventions were eligible for inclusion and publications were screened for relevance by two independent reviewers. Where two or more studies reported the same outcomes, results were pooled. Evidence quality was graded using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology (Figure 1).1

Figure 1: ECDC systematic review to assess the effectiveness and safety of enhanced inactivated influenza vaccines: methods.

<h2>Results of the ECDC systematic literature review for recombinant haemagglutinin vaccines1</h2>
Evidence reviewed was the two pivotal&nbsp;<a href="${link:{uuid:{1b34dd78-c3db-424c-997c-a35cbbf1e482},repository:{products},path:{/UK/supemtek}}}" target="_self">Supemtek</a>&nbsp;clinical trials versus standard-dose egg-based quadrivalent flu vaccine.

<table align="center" border="1" cellpadding="20" cellspacing="1" style="width:100%;">
 <tbody>
 <tr>
 <td style="background-color: rgb(82, 93, 163);">Protection*</td>
 <td style="background-color: rgb(82, 93, 163);">Safety profile</td>
 <td style="background-color: rgb(82, 93, 163);">Evidence†</td>
 </tr>
 <tr>
 <td>“...Studies appear to suggest that recombinant HA vaccines may offer better protection than no vaccination or standard influenza vaccines, with some possible cross-protection to drift variants”</td>
 <td>“...Findings of this review suggest that the safety profile of recombinant HA vaccines is largely similar to that of traditional influenza vaccines in terms of local and systemic effects (low-moderate certainty evidence)”</td>
 <td>“...Data related to efficacy or effectiveness for recombinant HA vaccines were limited to two efficacy randomised controlled trials”</td>
 </tr>
 </tbody>
</table>

*Versus traditional standard-dose quadrivalent influenza vaccination (QIVe) in adults ≥50 years of age.
†Trial 1 Randomised controlled trial to evaluate the protective efficacy of Supemtek (n=4,301) (45 µg of recombinant HA per strain, 180 µg of protein per dose) versus standard-dose egg-based quadrivalent influenza vaccine (QIVe) (n=4,303) (15 µg of HA per strain, 60 µg of protein per dose) during the 2014/15 influenza season. Primary endpoint: relative vaccine efficacy (rVE) against RT-PCR-confirmed, protocol-defined, influenza-like illness caused by any influenza strain starting 14 days or more after vaccination in adults aged 50+ years. The study was designed to demonstrate non-inferiority of Supemtek in terms of rVE. Trial 2: Observer-blind, randomised, active-controlled trial to evaluate immunogenicity of Supemtek (n=998) versus standard-dose QIVe (n=332) during the 2014/15 influenza season. Co-primary endpoints: non-inferiority of HA inhibition (HAI) seroconversion rates (SCRs) and post-vaccination geometric mean titre (GMT) ratios for each antigen in ambulatory, medically stable adults 18–49 years of age.2,3

<h3>Abbreviations</h3>

An ECDC systematic literature review of the efficacy, effectiveness and safety of enhanced inactivated flu vaccines.

INFLUENZA

VACCINES

Enhanced Inactivated Flu Vaccines

<a href="${link:{uuid:{8cd02cf2-bd72-495f-b720-698ef8d3f0da},repository:{dam},path:{/Portal/UK/Prescribing-links/Toujeo.pdf}}}" target="_blank">Prescribing Information Toujeo (insulin glargine 300 units/mL)</a>

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There is an intense desire to participate in fasting during Ramadan, even among the people who could seek exemption1. Discover the ORION study and the 2021 IDF-DAR Practical guidance.
<h2>Summary</h2>

Download a summary of the ORION study. Real-world safety and effectiveness of Toujeo®&nbsp;in patients with Type 2 Diabetes who choose to fast during Ramadan.

Read the full publication of the ORION observational study in patients with Type 2 Diabetes who choose to fast during Ramadan.

<a href="/uk/type-2-diabetes">SEE MORE FROM SCIENCE</a>

<h3>Toujeo</h3>
Toujeo®&nbsp;is indicated as treatment of diabetes mellitus in adults,&nbsp;adolescents and children from the age of 6 years.&nbsp;&nbsp;

<h3>Patient Website</h3>
Find resources and support for your patients on Toujeo®. Help patients understand the basics of living and staying well with diabetes and how to have a positive start and experience with the medication prescribed to them.

Toujeo® (insulin glargine 300 units/mL) Prescribing Information

TYPE-2-DIABETES

DIABETES

ORION Observational Study

<h2>BRIGHT study</h2>
In this 7-minute video Dr. Alice Cheng tells you about the BRIGHT study, the head-to-head trial comparing Toujeo®&nbsp;vs insulin degludec 100 units/mL meeting the primary endpoint. She tells about the results and why they are relevant and important to her clinical practices, in helping the right patients on the right treatment.

<h3>Toujeo</h3>
Toujeo®&nbsp;is indicated as treatment of diabetes mellitus in adults,&nbsp;adolescents and children from the age of 6 years.&nbsp;

Video: BRIGHT study

<a href="${link:{uuid:{8cd02cf2-bd72-495f-b720-698ef8d3f0da},repository:{dam},path:{/Portal/UK/Prescribing-links/Toujeo.pdf}}}" target="_blank">Prescribing Information Toujeo (insulin glargine 300 units/mL)</a> <a href="${link:{uuid:{8f132346-a5c2-470d-8368-64ab56220e08},repository:{dam},path:{/Portal/UK/Prescribing-links/Lantus_GB_NI_PI.pdf}}}" target="_blank">Prescribing Information Lantus (insulin glargine 100 units/mL)</a>

<h2>Edition Junior</h2>
Download this clinical summary to read about the benefits of Toujeo®&nbsp;in children and adolescents from the age of 6 years in this randomised trial. Edition Junior was a 6 month long, open-label, double arm, parallel group, non-inferiority study in 463 children with T1DM. The aim of the study was to demonstrate non-inferiority of Toujeo®&nbsp;vs insulin glargine 100 U/mL from baseline to Week 26.

<a href="/uk/type-1-diabetes">SEE MORE FROM SCIENCE</a>

Toujeo® (insulin glargine 300 units/mL) Prescribing Information 

Lantus® (insulin glargine 100 units/mL) Prescribing Information 

TYPE-1-DIABETES

T1 Edition Junior Study

<h2>T1-Meta Analysis</h2>
Download this clinical summary to read about the benefits of Toujeo®&nbsp;in this post-hoc meta-analysis of three Edition 6 month, phase III, randomised trials. The study aimed to explore the risk of hypoglycaemia with Toujeo®&nbsp;vs insulin glargine 100U/mL in a broad pool of people with T1DM including children over the age of 6.

T1DM - Meta-Analysis

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Development of ADCT involved literature review as well as interviews with patients and physicians, and was funded by Sanofi and Regeneron.

The ADCT gives a measure of how controlled your patient’s eczema is. Use these 6 concise questions to evaluate all dimensions of atopic dermatitis control.

Atopic dermatitis, a type of eczema, may be affecting your patient’s life in more ways than you know.

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