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National Guideline Alliance (UK). Cystic Fibrosis: Diagnosis and management. London: National Institute for Health and Care Excellence (NICE); 2017 Oct 25. (NICE Guideline, No. 78.)

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Cystic Fibrosis: Diagnosis and management.

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Table 162Research recommendation justification

Research questionShould all children with meconium ileus receive ursodeoxycholic acid from diagnosis?
Why this is needed
Importance to ‘patients’ or the populationLiver disease is the third commonest cause of death in cystic fibrosis. Meconium ileus is a risk factor for the development of cystic fibrosis related liver disease. It is possible that ursodeoxycholic acid (UDCA) decreases the incidence or severity of cystic fibrosis related liver disease. UDCA is relatively inexpensive and well tolerated, and if it decreased the incidence or severity of cystic fibrosis related liver disease this could improve quality of life and decrease mortality.
Relevance to NICE guidanceIf UDCA changed the incidence or severity of cystic fibrosis related liver disease, this would change the recommendations for monitoring and treatment.
  • High: the research is essential to inform future updates of key recommendations in the guideline.
Relevance to the NHSFinancial cost of regular therapy and treatment burden to the patient. Cost savings if decreased incidence and severity of liver disease
National prioritiesNo document identified.
Current evidence baseUDCA can improve deranged biochemical tests of liver function, but it is unclear whether if given to high risk groups it is able to alter the incidence or severity of disease.
EqualityThis intervention is of particular relevance to infants born with meconium ileus who are at increased risk of cystic fibrosis related liver disease.
FeasibilityThe proposed research can be carried out within a realistic timescale and at an acceptable cost.
There are no ethical or technical issues.
Other commentsNone

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