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Heart Failure with Reduced Ejection Fraction (HFrEF) — UKMLA MCQ

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HardCardiologyHeart Failure with Reduced Ejection Fraction (HFrEF)UKMLAMRCP Part 1

An adult has visual impairment from macular oedema following a branch retinal vein occlusion. Faricimab, aflibercept and ranibizumab are each clinically suitable after retinal assessment. Which selection principle follows NICE?

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Correct answer: E — Use the least expensive suitable anti-VEGF treatment after shared discussion

The best answer is “Use the least expensive suitable anti-VEGF treatment after shared discussion”. TA1004 covers visual impairment from macular oedema after either central or branch retinal vein occlusion. When faricimab and other recommended anti-VEGF agents are suitable, NICE directs use of the least expensive after discussing advantages, administration, dose and commercial arrangements. The appraisal does not require conversion to central occlusion or combination intravitreal therapy.

Reference: NICE TA1004, Faricimab for visual impairment caused by macular oedema after retinal vein occlusion: https://www.nice.org.uk/guidance/ta1004/chapter/1-Recommendations