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Published: 25 February, 2022


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February was Ovarian Cancer Awareness Month

This month is Ovarian Cancer Awareness Month. Ovarian cancer is the leading cause of gynaecological cancer related deaths in New Zealand, and it is estimated that one person dies of ovarian cancer every 48 hours in New Zealand.

Symptoms are often vague, non-specific and not gynaecological in nature which makes early detection challenging; approximately 85% of people are diagnosed with ovarian cancer in the later stages of disease where treatment options are limited.

Early detection relies on recognising the significance of the symptoms and signs of ovarian cancer that patients present with as there is no screening test available.

Further information and resources on gynaecological cancers, is available from: Te Aho o Te Kahu – Cancer Control Agency.

Patient information is available from: Talk Peach Gynaecological Foundation, Cure Our Ovarian Cancer and the New Zealand Gynaecological Cancer Foundation.

Later this year we will be publishing a series on gynaecological cancers, supported by Te Aho o Te Kahu – Cancer Control Agency, covering the early detection, follow-up and surveillance of cervical, ovarian, uterine, vaginal and vulval cancers.


Abortion telehealth service to launch this year

Associate Health Minister Dr Ayesha Verrall has announced a new national abortion telehealth service, Decide, that will be launched in three phases later this year. Information, advice and counselling will be available via a free dedicated number, 0800 DECIDE. The initiative will be jointly operated by Family Planning New Zealand and Magma Healthcare (The Woman’s Clinic) and funded by the Ministry of Health.


Medicines Monitoring Communications

Possible risk of vasculitis with vildagliptin products

Medsafe has issued a Monitoring Communication on the possible risk of vasculitis with the use of vildagliptin products (Galvus, Galvumet). Currently, vasculitis is not listed as a reaction on vildagliptin data sheets. Healthcare professionals and patients are encouraged to report any cases of vasculitis associated with vildagliptin use to the Centre for Adverse Reactions Monitoring (CARM).

Medsafe has previously cautioned prescribers to be aware of the potential increased risk of angioedema in patients who take vildagliptin and an ACE inhibitor. See Bulletin 20 for further information

For further information on the use of vildagliptin in patients with type 2 diabetes, see: https://bpac.org.nz/2021/diabetes-vildagliptin.aspx

Dihydrocodeine: review of risks and benefits

As reported in Bulletin 32, in August 2021, Medsafe sought a review into the risks and benefits of dihydrocodeine as part of an ongoing evaluation on the risks of opioid misuse and dependence. In February, 2022, Medsafe issued an update to the original communication following review by the Medicines Adverse Reaction Committee (MARC) in December, 2021. The Committee found insufficient evidence to recommend revoking consent of the approved dihydrocodeine products in New Zealand and recommended imposing two conditions on the use of these medicines.

Buccaline: review of the benefits and risks

Buccaline is a Pharmacist Only medicine indicated for oral antibacterial prophylaxis of complications of colds. Following a review by the Medicines Adverse Reactions Committee, on 18 January, 2022, Medsafe issued a notice to the sponsor to provide evidence of the efficacy and safety of Buccaline tablets.


Consultation on new warning and advisory statements for opioid medicines

Medsafe has issued a consultation proposing a new warning and advisory statement for opioid medicines. In June, 2021, the Medicines Adverse Reactions Committee recommended a warning and advisory statement be added for all opioid medicines following international and national concerns over opioid abuse, misuse and dependence.

Currently, codeine is the only opioid medicine that has a warning and advisory statement – "codeine is an addictive substance". Proposed warning and advisory statements for all opioid medicines include:

  • [Name of opioid] is an addictive substance; or
  • Use of this medicines has the risks of overdose and dependence; or
  • Contains opioid

Read more about the proposal here, including how to submit a response.

For information on the role of opioids in pain management, see: https://bpac.org.nz/2018/opioids.aspx and https://bpac.org.nz/2018/opioids-chronic.aspx


Ethinyloestradiol 10 microgram tablets to be discontinued

PHARMAC has been advised by the supplier that ethinyloestradiol 10 microgram tablets indicated for post-menopausal symptoms including osteoporosis prophylaxis, will be discontinued with stock anticipated to run out mid-to-late 2022. Patients currently taking ethinyloestradiol need to be transitioned to a different treatment and no new patients should be started on ethinyloestradiol.


Paper of the Week: Clinician's opinions on HPV self-screening

After several years of consultation, it is now confirmed that from July, 2023, the primary test for cervical cancer screening will be human papillomavirus (HPV) testing. Testing can be carried out by the clinician or by the patient in private at the health clinic or at home (or another non-clinical location). If the patient tests positive for HPV, this is followed up by a speculum examination and cervical smear or in some cases direct referral for colposcopy. Routine cervical screening will occur every five years. The combination of HPV testing and follow-up is more effective at detecting cervical cancer than the current method and the new screening programme is expected to result in reduced rates of cervical cancer, while also addressing equity issues. Pilot programmes are now underway in some regions of New Zealand.

The move to HPV testing signifies a major shift in practice for many clinicians, and there will be varying degrees of confidence with this. HPV testing as the primary method of cervical screening began in 2017 in Australia. In Canada, cervical Pap smear is the primary screening method, but some provinces have recommended moving to HPV testing. In a recently published study, researchers surveyed primary care clinicians (doctors and nurses) and obstetrician-gynaecologists about their knowledge, acceptability and opinions on HPV self-screening. Overall, knowledge about self-screening was poor but it was generally acceptable if certain test conditions were met. There was concern about missed opportunities to examine the patient and address other health needs. The findings of the study make interesting reading for clinicians in New Zealand.


If you have any information you would like us to add to our next bulletin, please email: editor@bpac.org.nz

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