Published: 11 February, 2022
Contents
Rosuvastatin: who should be prescribed this statin?
We have just published a new article detailing who rosuvastatin is recommended for,
and how to prescribe it.
Rosuvastatin is a more potent statin than other currently funded options. It is now funded for people with an increased risk of cardiovascular complications associated with high lipid levels. To meet Special Authority eligibility criteria for funded treatment, many people will need to have already trialled other statins and not been successful in reducing their LDL-C below a certain level, but rosuvastatin may be considered as a first-line treatment for Māori and Pacific peoples, who are at greater CVD risk.
Acknowledging World Cancer Day
Each year in New Zealand, approximately 25,000 people are diagnosed with cancer. It is estimated that up to half of all cancers are potentially preventable by reducing exposure to modifiable risk factors. To mark World Cancer Day that was held on 4th February, Te Aho O Te Kahu – Cancer Control Agency, released Pūrongo Ārai Mate Pukupuku, the Cancer Prevention Report.
This report focuses on providing evidence-based, best-practice interventions to prevent the development of cancer by targeting the following modifiable risk factors: tobacco exposure, alcohol consumption, poor nutrition, excess body weight, physical inactivity, excessive exposure to ultraviolet radiation and chronic infections, e.g. Helicobacter pylori, HPV, HIV, hepatitis B and C. To read the full report, including their recommendations, click here.
Did you know that we have a dedicated Cancer Care section on our website? Articles and other resources, supported by Te Aho O Te Kahu – Cancer Control Agency, cover the early detection, follow-up and surveillance of many cancers including, bowel, lung and melanoma. Keep your eye on our website for upcoming cancer care articles.
COVID-19 medicines update in the NZF
In the February release of the NZF, information has been added on treatments available in New Zealand for COVID-19. The changes are detailed here. Did you know that you can receive notification of any significant changes to the NZF and NZFC direct to your email each month? Sign up here
Casirivimab + imdevimab
A new monograph has been added to the NZF and NZFC for casirivimab + imdevimab (Ronapreve). This monograph details dosage information for the treatment of COVID-19 in those at risk of severe disease and not requiring supplemental oxygen; single dose prevention of COVID-19 in those exposed to SARS-CoV-2 who are not vaccinated, or are vaccinated but have a medical condition making them unlikely to adequately respond to vaccination (N.B. this is not a substitute for vaccination and is intended for people at high risk of developing severe symptoms); and repeat dosing for prevention of COVID-19 in those with ongoing exposure (greater than four weeks) to SARS-CoV-2 and have a medical condition making them unlikely to adequately respond to vaccination.
Tocilizumab
The monograph in the NZFC for tocilizumab has been updated with a new indication and dose for moderate to severe COVID-19 infection in children (unapproved indication); this indication for adults had previously been added to NZF.
We previously covered funded medicines for COVID-19 in New Zealand in Bulletin 38
Resources for COVID-19 vaccination in children
Children aged 5 – 11 years have been eligible to receive the Pfizer COVID-19 vaccine since mid-January. Children in this age group receive a paediatric formulation (10 micrograms/dose), given as two doses spaced eight weeks apart (or a minimum of 21 days).
The Immunisation Advisory Centre has developed a range of resources for health care professionals about COVID-19 vaccination in children. It is important to keep up to date with the latest available resources, even if vaccinating children is not part of your usual scope, as you may need to provide advice and discussion with caregivers. Some of the resources available include:
Starship Child Health resources for COVID-19:
Further information on COVID-19 vaccination in children is available from: https://starship.org.nz/guidelines/covid-19-vaccination-in-children/
Further information on managing COVID-19 infection in children is available from: https://starship.org.nz/guidelines/covid-19-disease-in-children/
Widened access to funded influenza vaccination
It has been reported in the general media that the eligibility criteria are to be widened for funded influenza vaccination in 2022. It is thought that the focus will be on reducing the age of eligibility for at-risk populations. We will report on the updated criteria when the information is released by the Ministry of Health.
Antipsychotic switching tool
A useful tool is available from NPS Australia that assists prescribers when changing a patient's antipsychotic treatment. Using the interactive tool, the prescriber enters the formulation (oral or depot), the current medicine the patient is prescribed and the medicine they want to switch the patient to. This then generates prescribing information about how to stop one medicine and start the next, along with key clinical issues to be aware of. All antipsychotic medicines currently funded in New Zealand are included in the tool.
Paper of the Week: Something for everyone
This week we have found some great content, but it was just too hard to choose only one, so here is a selection for you all to enjoy.
Muscle injury after return to exercise post-lockdown
While lockdowns are now (hopefully) a thing of the past, many people will still have to isolate and for some, this may be for an extended period of time. A recent letter published in the New Zealand Medical Journal raises a concerning issue about several cases of exertional rhabdomyolysis after returning to exercise following a COVID-19 lockdown. Click here to find out more.
Ethnic differences in cancer rates among people with type 2 diabetes in New Zealand
Continuing with the theme of cancer prevention in this week's bulletin, we would like to highlight a New Zealand-based study just published in the JAMA that assessed whether site-specific cancers differed among Māori, Pacific peoples and New Zealand European adults with type 2 diabetes from 1994 – 2018. Māori had a significantly greater risk of liver, gallbladder, lung, thyroid and cervical cancer, but a lower risk of bowel and bladder cancer and melanoma. Click here to find out more about the results of the study.
The Curbsiders are back!
We are still really enjoying The Curbsiders, and hope they have made it to some of your play lists too. In a throwback to ‘podcast of the week’, we have two interesting topics to share with you this week.
Despite not yet being a hot topic in New Zealand, we can all expect sooner or later to have to get to know the ins and outs of "Long COVID". The Curbsiders are joined by Dr Monica Verduzco-Gutierrez as she discusses the long-term effects following infection with COVID-19. Take a listen here as she details the epidemiology, pathogenesis, ongoing symptoms, e.g. fatigue, dyspnoea, neuropsychiatric symptoms, and the management of patients with Long COVID. Skip ahead to '14.15' if you don't want to listen to the (rather long!) preamble.
Your heart will skip a beat while you listen to the second of this week’s podcasts! Join Dr Joshua Cooper, the director of cardiac electrophysiology at Temple University Hospital, Philadelphia, as he discusses all things palpitations. Click here to listen. Skip ahead to '9.55' for the main content.
This Bulletin is supported by the South Link Education Trust
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