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386886
star this property registered interest false more like this
star this property date remove filter
star this property answering body
Department of Health more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health more like this
star this property answering dept sort name Health more like this
unstar this property hansard heading Amyloidosis and Multiple Myeloma more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government whether they will place in the Library of the House any publications resulting from the phase 3 clinical trials approved for the potential treatment of systemic amyloidosis or multiple myeloma; and what is the National Institute of Health Research’s assessment of progress in these areas. more like this
star this property tabling member printed
Lord Willis of Knaresborough more like this
star this property uin HL995 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2015-07-14more like thismore than 2015-07-14
star this property answer text <p>There are four trials for systemic amyloidosis that are designated as ‘ongoing’ in the United Kingdom. These are being conducted by two commercial sponsors, Millennium Pharmaceuticals Inc and A.T. Development Switzerland Sarl (two studies), and one non-commercial sponsor, European Myeloma Network.</p><p> </p><p> </p><p> </p><p>Clinical trial sponsors are required to publish a summary of their trial results to the EU Clinical Trials Register within one year of their trial completing. At that point, these results will become publically available on the EU Clinical Trials Register</p><p> </p><p> </p><p> </p><p>The Department of Health, which funds the National Institute for Health Research (NIHR), is a member of the National Cancer Research Institute (NCRI). NCRI Clinical Studies Groups (CSGs) bring together clinicians, scientists, statisticians and lay representatives to coordinate development of a strategic portfolio of trials within their field. All CSGs interact with clinical research networks, funders (including NIHR) and researchers to develop studies aimed at improving outcomes for patients. The Haematological Oncology CSG has a Myeloma Subgroup and its 2013-14 annual report that includes an assessment of progress in these areas is attached and available on the NCRI website at:</p><p> </p><p><a href="http://csg.ncri.org.uk/wp-content/uploads/2014/11/NCRI-Haem-Onc-CSG-Annual-Report-2013-14.pdf" target="_blank">http://csg.ncri.org.uk/wp-content/uploads/2014/11/NCRI-Haem-Onc-CSG-Annual-Report-2013-14.pdf</a>.</p><p> </p><p> </p><p> </p><p>We cannot comment on commercial considerations. When the results are known, the commercial potential of these trial’s products will be a matter for the respective trial sponsors.</p><p> </p>
star this property answering member printed Lord Prior of Brampton more like this
star this property grouped question UIN
HL996 more like this
HL997 more like this
star this property question first answered
less than 2015-07-14T15:34:29.197Zmore like thismore than 2015-07-14T15:34:29.197Z
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property attachment
1
star this property file name NCRI-Haem-Onc-CSG-Annual-Report-2013-14.pdf more like this
star this property title 2013-14 Annual Report more like this
star this property tabling member
4151
star this property label Biography information for Lord Willis of Knaresborough more like this
386887
star this property registered interest false more like this
star this property date remove filter
star this property answering body
Department of Health more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health more like this
star this property answering dept sort name Health more like this
unstar this property hansard heading Amyloidosis more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government whether there are currently any trials for systemic amyloidosis in humans being conducted by the National Institute of Health Research charities or the commercial sector. more like this
star this property tabling member printed
Lord Willis of Knaresborough more like this
star this property uin HL996 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2015-07-14more like thismore than 2015-07-14
star this property answer text <p>There are four trials for systemic amyloidosis that are designated as ‘ongoing’ in the United Kingdom. These are being conducted by two commercial sponsors, Millennium Pharmaceuticals Inc and A.T. Development Switzerland Sarl (two studies), and one non-commercial sponsor, European Myeloma Network.</p><p> </p><p> </p><p> </p><p>Clinical trial sponsors are required to publish a summary of their trial results to the EU Clinical Trials Register within one year of their trial completing. At that point, these results will become publically available on the EU Clinical Trials Register</p><p> </p><p> </p><p> </p><p>The Department of Health, which funds the National Institute for Health Research (NIHR), is a member of the National Cancer Research Institute (NCRI). NCRI Clinical Studies Groups (CSGs) bring together clinicians, scientists, statisticians and lay representatives to coordinate development of a strategic portfolio of trials within their field. All CSGs interact with clinical research networks, funders (including NIHR) and researchers to develop studies aimed at improving outcomes for patients. The Haematological Oncology CSG has a Myeloma Subgroup and its 2013-14 annual report that includes an assessment of progress in these areas is attached and available on the NCRI website at:</p><p> </p><p><a href="http://csg.ncri.org.uk/wp-content/uploads/2014/11/NCRI-Haem-Onc-CSG-Annual-Report-2013-14.pdf" target="_blank">http://csg.ncri.org.uk/wp-content/uploads/2014/11/NCRI-Haem-Onc-CSG-Annual-Report-2013-14.pdf</a>.</p><p> </p><p> </p><p> </p><p>We cannot comment on commercial considerations. When the results are known, the commercial potential of these trial’s products will be a matter for the respective trial sponsors.</p><p> </p>
star this property answering member printed Lord Prior of Brampton more like this
star this property grouped question UIN
HL995 more like this
HL997 more like this
star this property question first answered
less than 2015-07-14T15:34:29.297Zmore like thismore than 2015-07-14T15:34:29.297Z
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property attachment
1
star this property file name NCRI-Haem-Onc-CSG-Annual-Report-2013-14.pdf more like this
star this property title 2013-14 Annual Report more like this
star this property tabling member
4151
star this property label Biography information for Lord Willis of Knaresborough more like this
386888
star this property registered interest false more like this
star this property date remove filter
star this property answering body
Department of Health more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health more like this
star this property answering dept sort name Health more like this
unstar this property hansard heading Amyloidosis more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government which of the four phase 2 or 3 clinical trials for systemic amyloidosis approved since 2004 are still ongoing; and whether any of the trials have produced sufficient positive outcomes to encourage commercial development. more like this
star this property tabling member printed
Lord Willis of Knaresborough more like this
star this property uin HL997 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2015-07-14more like thismore than 2015-07-14
star this property answer text <p>There are four trials for systemic amyloidosis that are designated as ‘ongoing’ in the United Kingdom. These are being conducted by two commercial sponsors, Millennium Pharmaceuticals Inc and A.T. Development Switzerland Sarl (two studies), and one non-commercial sponsor, European Myeloma Network.</p><p> </p><p> </p><p> </p><p>Clinical trial sponsors are required to publish a summary of their trial results to the EU Clinical Trials Register within one year of their trial completing. At that point, these results will become publically available on the EU Clinical Trials Register</p><p> </p><p> </p><p> </p><p>The Department of Health, which funds the National Institute for Health Research (NIHR), is a member of the National Cancer Research Institute (NCRI). NCRI Clinical Studies Groups (CSGs) bring together clinicians, scientists, statisticians and lay representatives to coordinate development of a strategic portfolio of trials within their field. All CSGs interact with clinical research networks, funders (including NIHR) and researchers to develop studies aimed at improving outcomes for patients. The Haematological Oncology CSG has a Myeloma Subgroup and its 2013-14 annual report that includes an assessment of progress in these areas is attached and available on the NCRI website at:</p><p> </p><p><a href="http://csg.ncri.org.uk/wp-content/uploads/2014/11/NCRI-Haem-Onc-CSG-Annual-Report-2013-14.pdf" target="_blank">http://csg.ncri.org.uk/wp-content/uploads/2014/11/NCRI-Haem-Onc-CSG-Annual-Report-2013-14.pdf</a>.</p><p> </p><p> </p><p> </p><p>We cannot comment on commercial considerations. When the results are known, the commercial potential of these trial’s products will be a matter for the respective trial sponsors.</p><p> </p>
star this property answering member printed Lord Prior of Brampton more like this
star this property grouped question UIN
HL995 more like this
HL996 more like this
star this property question first answered
less than 2015-07-14T15:34:29.553Zmore like thismore than 2015-07-14T15:34:29.553Z
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property attachment
1
star this property file name NCRI-Haem-Onc-CSG-Annual-Report-2013-14.pdf more like this
star this property title 2013-14 Annual Report more like this
star this property tabling member
4151
star this property label Biography information for Lord Willis of Knaresborough more like this
386882
star this property registered interest false more like this
star this property date remove filter
star this property answering body
Department for Energy and Climate Change more like this
star this property answering dept id 63 more like this
star this property answering dept short name Energy and Climate Change more like this
star this property answering dept sort name Energy and Climate Change more like this
unstar this property hansard heading Carbon Emissions more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government what proportion of their 2020 carbon emissions reduction target they intend to achieve through energy efficiency measures. more like this
star this property tabling member printed
Lord Judd more like this
star this property uin HL991 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2015-07-07more like thismore than 2015-07-07
star this property answer text <p>The Climate Change Act (2008) requires the Government to set legally binding ‘carbon budgets’ to meet the objective of reducing emissions by at least 80% in 2050 from 1990 levels. The Act requires that the UK’s emissions in the third carbon budget period, which covers 2020, are at least 34% below the 1990 baseline for emissions.</p><p>The Government has not set specific targets for how much of the emissions reductions required for each carbon budget should come from different emissions sources, for example heat, electricity or transport. This is to provide sufficient flexibility to ensure carbon savings are delivered across the economy in the most cost effective way.</p><p>However, DECC does produce projections of UK emissions that account for the impact of Government policies. The last projections published in September 2014 [1] showed that the UK was on track to meet the second (2013-17) and third (2018-22) budgets having already met the first carbon budget (2008-12).</p><p>In 2020, policies [2] which drive improvements in energy efficiency (across all sectors) are projected to contribute 61% of the total reduction in emissions and policies influencing the uptake of low-carbon heat technologies are projected to contribute 5%. Other policies such as Building Regulations also support the reduction of heat emissions from buildings for example through the requirement to install a condensing boiler in most cases when a boiler needs to be replaced.</p><p><em><strong>[1]</strong></em><em> Updated Energy and Emissions Projections: 2014 (DECC)</em></p><p><strong><em> [</em></strong><strong><em>2]</em></strong><em> Source: Annex D of the Updated Energy and Emissions Projections (EEP): 2014 (DECC). Based on all policies listed in EEP, including those introduced before as well as after the publication of the Low Carbon Transition Plan (LCTP) 2009</em></p><p> </p><p> </p><p> </p>
star this property answering member printed Lord Bourne of Aberystwyth more like this
star this property grouped question UIN HL992 more like this
star this property question first answered
less than 2015-07-07T16:31:57.44Zmore like thismore than 2015-07-07T16:31:57.44Z
star this property answering member
4282
star this property label Biography information for Lord Bourne of Aberystwyth more like this
star this property tabling member
1660
star this property label Biography information for Lord Judd more like this
386883
star this property registered interest false more like this
star this property date remove filter
star this property answering body
Department for Energy and Climate Change more like this
star this property answering dept id 63 more like this
star this property answering dept short name Energy and Climate Change more like this
star this property answering dept sort name Energy and Climate Change more like this
unstar this property hansard heading Carbon Emissions more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government what proportion of their 2020 carbon emissions reduction target they intend to achieve through the development of thermal heating capacity in the United Kingdom. more like this
star this property tabling member printed
Lord Judd more like this
star this property uin HL992 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2015-07-07more like thismore than 2015-07-07
star this property answer text <p>The Climate Change Act (2008) requires the Government to set legally binding ‘carbon budgets’ to meet the objective of reducing emissions by at least 80% in 2050 from 1990 levels. The Act requires that the UK’s emissions in the third carbon budget period, which covers 2020, are at least 34% below the 1990 baseline for emissions.</p><p>The Government has not set specific targets for how much of the emissions reductions required for each carbon budget should come from different emissions sources, for example heat, electricity or transport. This is to provide sufficient flexibility to ensure carbon savings are delivered across the economy in the most cost effective way.</p><p>However, DECC does produce projections of UK emissions that account for the impact of Government policies. The last projections published in September 2014 [1] showed that the UK was on track to meet the second (2013-17) and third (2018-22) budgets having already met the first carbon budget (2008-12).</p><p>In 2020, policies [2] which drive improvements in energy efficiency (across all sectors) are projected to contribute 61% of the total reduction in emissions and policies influencing the uptake of low-carbon heat technologies are projected to contribute 5%. Other policies such as Building Regulations also support the reduction of heat emissions from buildings for example through the requirement to install a condensing boiler in most cases when a boiler needs to be replaced.</p><p><em><strong>[1]</strong></em><em> Updated Energy and Emissions Projections: 2014 (DECC)</em></p><p><strong><em> [</em></strong><strong><em>2]</em></strong><em> Source: Annex D of the Updated Energy and Emissions Projections (EEP): 2014 (DECC). Based on all policies listed in EEP, including those introduced before as well as after the publication of the Low Carbon Transition Plan (LCTP) 2009</em></p><p> </p><p> </p><p> </p>
star this property answering member printed Lord Bourne of Aberystwyth more like this
star this property grouped question UIN HL991 more like this
star this property question first answered
less than 2015-07-07T16:31:57.56Zmore like thismore than 2015-07-07T16:31:57.56Z
star this property answering member
4282
star this property label Biography information for Lord Bourne of Aberystwyth more like this
star this property tabling member
1660
star this property label Biography information for Lord Judd more like this
386923
star this property registered interest false more like this
star this property date remove filter
star this property answering body
Department of Health more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health more like this
star this property answering dept sort name Health more like this
unstar this property hansard heading Vitamin B12 more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government what steps they are taking to find an alternative and reliable test to assess the vitamin B12 status of the population; and what level of false high results the current test provides. more like this
star this property tabling member printed
The Countess of Mar more like this
star this property uin HL1032 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2015-07-14more like thismore than 2015-07-14
star this property answer text <p>The diagnosis and treatment of pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, is well established and reported in the British Committee for Standards in Haematology (BCSH) guidance document, <em>Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders</em>, which was updated in May 2014. A copy of the BCSH guidance document is attached.</p><p> </p><p>The BCSH operates independently of the Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice, in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate.</p><p> </p><p> </p><p> </p><p>The BCSH guidance sets out that cobalamin status is the recommended first line diagnostic test. The Department has no data relating to false positive results in relation to the test. The guidance also states that clinical picture is the most important factor in assessing the significance of the test results.</p><p> </p><p> </p><p> </p><p>When anaemia is diagnosed, most patients respond well to treatment through quarterly intramuscular injection of vitamin B12. Whilst some patients with pernicious anaemia might prefer to have more frequent injections, or for other forms of vitamin B12 to be self-administered, these are matters for individual patients to discuss with their general practitioners.</p><p> </p><p> </p><p> </p><p>Although the Medicines Healthcare products Regulatory Agency is currently reviewing claims made by some clinics that are administering vitamins and minerals intravenously for nutritional therapy purposes, the agency has not encountered any clinics making claims to treat pernicious anaemia. In addition, the Department does not have any information regarding patients purchasing additional supplies of B12 from unregulated sources.</p><p> </p><p> </p><p> </p><p>Regarding the mandatory fortification of flour with folic acid, the Scientific Advisory Committee on Nutrition recommended a number of measures to ensure monitoring and surveillance of the impact of fortification of flour, should it be implemented. This included appropriate systems to monitor any potential adverse effects, including cancer and a review of the evidence on benefits and postulated risks after five years. The National Diet and Nutrition Survey monitors folate intakes and the most recent data, which was published earlier this year, will be carefully considered alongside other information sources before any decision is made on mandatory fortification.</p><p> </p><p> </p><p> </p><p>The Department has made no assessment of the social and economic costs of misdiagnosis or late diagnosis of pernicious anaemia and other vitamin B12 deficiencies.</p><p> </p>
star this property answering member printed Lord Prior of Brampton more like this
star this property grouped question UIN
HL1033 more like this
HL1034 more like this
HL1035 more like this
HL1036 more like this
HL1042 more like this
star this property question first answered
less than 2015-07-14T15:00:41.673Zmore like thismore than 2015-07-14T15:00:41.673Z
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property attachment
1
star this property file name colbalamin and folate disorders.pdf more like this
star this property title BSCH Guidance more like this
star this property tabling member
1861
star this property label Biography information for The Countess of Mar more like this
386924
star this property registered interest false more like this
star this property date remove filter
star this property answering body
Department of Health more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health more like this
star this property answering dept sort name Health more like this
unstar this property hansard heading Vitamin B12 more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government whether they plan to review how pernicious anaemia and other symptoms of vitamin B12 deficiency in the United Kingdom population are diagnosed and treated, particularly taking into account the neurological and mental health impact of any failure to diagnose quickly and accurately; and, if not, why not. more like this
star this property tabling member printed
The Countess of Mar more like this
star this property uin HL1033 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2015-07-14more like thismore than 2015-07-14
star this property answer text <p>The diagnosis and treatment of pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, is well established and reported in the British Committee for Standards in Haematology (BCSH) guidance document, <em>Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders</em>, which was updated in May 2014. A copy of the BCSH guidance document is attached.</p><p> </p><p>The BCSH operates independently of the Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice, in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate.</p><p> </p><p> </p><p> </p><p>The BCSH guidance sets out that cobalamin status is the recommended first line diagnostic test. The Department has no data relating to false positive results in relation to the test. The guidance also states that clinical picture is the most important factor in assessing the significance of the test results.</p><p> </p><p> </p><p> </p><p>When anaemia is diagnosed, most patients respond well to treatment through quarterly intramuscular injection of vitamin B12. Whilst some patients with pernicious anaemia might prefer to have more frequent injections, or for other forms of vitamin B12 to be self-administered, these are matters for individual patients to discuss with their general practitioners.</p><p> </p><p> </p><p> </p><p>Although the Medicines Healthcare products Regulatory Agency is currently reviewing claims made by some clinics that are administering vitamins and minerals intravenously for nutritional therapy purposes, the agency has not encountered any clinics making claims to treat pernicious anaemia. In addition, the Department does not have any information regarding patients purchasing additional supplies of B12 from unregulated sources.</p><p> </p><p> </p><p> </p><p>Regarding the mandatory fortification of flour with folic acid, the Scientific Advisory Committee on Nutrition recommended a number of measures to ensure monitoring and surveillance of the impact of fortification of flour, should it be implemented. This included appropriate systems to monitor any potential adverse effects, including cancer and a review of the evidence on benefits and postulated risks after five years. The National Diet and Nutrition Survey monitors folate intakes and the most recent data, which was published earlier this year, will be carefully considered alongside other information sources before any decision is made on mandatory fortification.</p><p> </p><p> </p><p> </p><p>The Department has made no assessment of the social and economic costs of misdiagnosis or late diagnosis of pernicious anaemia and other vitamin B12 deficiencies.</p><p> </p>
star this property answering member printed Lord Prior of Brampton more like this
star this property grouped question UIN
HL1032 more like this
HL1034 more like this
HL1035 more like this
HL1036 more like this
HL1042 more like this
star this property question first answered
less than 2015-07-14T15:00:41.81Zmore like thismore than 2015-07-14T15:00:41.81Z
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property attachment
1
star this property file name colbalamin and folate disorders.pdf more like this
star this property title BSCH Guidance more like this
star this property tabling member
1861
star this property label Biography information for The Countess of Mar more like this
386925
star this property registered interest false more like this
star this property date remove filter
star this property answering body
Department of Health more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health more like this
star this property answering dept sort name Health more like this
unstar this property hansard heading Vitamin B12 more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government what steps they are taking to ensure that a reliable test to assess the vitamin B12 status of the United Kingdom population is made available as a means to prevent serious and irreversible neurological damage before any mandatory fortification of flour with folic acid is introduced. more like this
star this property tabling member printed
The Countess of Mar more like this
star this property uin HL1034 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2015-07-14more like thismore than 2015-07-14
star this property answer text <p>The diagnosis and treatment of pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, is well established and reported in the British Committee for Standards in Haematology (BCSH) guidance document, <em>Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders</em>, which was updated in May 2014. A copy of the BCSH guidance document is attached.</p><p> </p><p>The BCSH operates independently of the Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice, in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate.</p><p> </p><p> </p><p> </p><p>The BCSH guidance sets out that cobalamin status is the recommended first line diagnostic test. The Department has no data relating to false positive results in relation to the test. The guidance also states that clinical picture is the most important factor in assessing the significance of the test results.</p><p> </p><p> </p><p> </p><p>When anaemia is diagnosed, most patients respond well to treatment through quarterly intramuscular injection of vitamin B12. Whilst some patients with pernicious anaemia might prefer to have more frequent injections, or for other forms of vitamin B12 to be self-administered, these are matters for individual patients to discuss with their general practitioners.</p><p> </p><p> </p><p> </p><p>Although the Medicines Healthcare products Regulatory Agency is currently reviewing claims made by some clinics that are administering vitamins and minerals intravenously for nutritional therapy purposes, the agency has not encountered any clinics making claims to treat pernicious anaemia. In addition, the Department does not have any information regarding patients purchasing additional supplies of B12 from unregulated sources.</p><p> </p><p> </p><p> </p><p>Regarding the mandatory fortification of flour with folic acid, the Scientific Advisory Committee on Nutrition recommended a number of measures to ensure monitoring and surveillance of the impact of fortification of flour, should it be implemented. This included appropriate systems to monitor any potential adverse effects, including cancer and a review of the evidence on benefits and postulated risks after five years. The National Diet and Nutrition Survey monitors folate intakes and the most recent data, which was published earlier this year, will be carefully considered alongside other information sources before any decision is made on mandatory fortification.</p><p> </p><p> </p><p> </p><p>The Department has made no assessment of the social and economic costs of misdiagnosis or late diagnosis of pernicious anaemia and other vitamin B12 deficiencies.</p><p> </p>
star this property answering member printed Lord Prior of Brampton more like this
star this property grouped question UIN
HL1032 more like this
HL1033 more like this
HL1035 more like this
HL1036 more like this
HL1042 more like this
star this property question first answered
less than 2015-07-14T15:00:41.947Zmore like thismore than 2015-07-14T15:00:41.947Z
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property attachment
1
star this property file name colbalamin and folate disorders.pdf more like this
star this property title BSCH Guidance more like this
star this property tabling member
1861
star this property label Biography information for The Countess of Mar more like this
386926
star this property registered interest false more like this
star this property date remove filter
star this property answering body
Department of Health more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health more like this
star this property answering dept sort name Health more like this
unstar this property hansard heading Vitamin B12 more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government what assessment they have made of the frequency at which patients with pernicious anaemia require vitamin B12 replacement therapy by injection; whether they have any evidence that patients are purchasing additional supplies from unregulated sources; and whether they will review current guidance. more like this
star this property tabling member printed
The Countess of Mar more like this
star this property uin HL1035 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2015-07-14more like thismore than 2015-07-14
star this property answer text <p>The diagnosis and treatment of pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, is well established and reported in the British Committee for Standards in Haematology (BCSH) guidance document, <em>Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders</em>, which was updated in May 2014. A copy of the BCSH guidance document is attached.</p><p> </p><p>The BCSH operates independently of the Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice, in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate.</p><p> </p><p> </p><p> </p><p>The BCSH guidance sets out that cobalamin status is the recommended first line diagnostic test. The Department has no data relating to false positive results in relation to the test. The guidance also states that clinical picture is the most important factor in assessing the significance of the test results.</p><p> </p><p> </p><p> </p><p>When anaemia is diagnosed, most patients respond well to treatment through quarterly intramuscular injection of vitamin B12. Whilst some patients with pernicious anaemia might prefer to have more frequent injections, or for other forms of vitamin B12 to be self-administered, these are matters for individual patients to discuss with their general practitioners.</p><p> </p><p> </p><p> </p><p>Although the Medicines Healthcare products Regulatory Agency is currently reviewing claims made by some clinics that are administering vitamins and minerals intravenously for nutritional therapy purposes, the agency has not encountered any clinics making claims to treat pernicious anaemia. In addition, the Department does not have any information regarding patients purchasing additional supplies of B12 from unregulated sources.</p><p> </p><p> </p><p> </p><p>Regarding the mandatory fortification of flour with folic acid, the Scientific Advisory Committee on Nutrition recommended a number of measures to ensure monitoring and surveillance of the impact of fortification of flour, should it be implemented. This included appropriate systems to monitor any potential adverse effects, including cancer and a review of the evidence on benefits and postulated risks after five years. The National Diet and Nutrition Survey monitors folate intakes and the most recent data, which was published earlier this year, will be carefully considered alongside other information sources before any decision is made on mandatory fortification.</p><p> </p><p> </p><p> </p><p>The Department has made no assessment of the social and economic costs of misdiagnosis or late diagnosis of pernicious anaemia and other vitamin B12 deficiencies.</p><p> </p>
star this property answering member printed Lord Prior of Brampton more like this
star this property grouped question UIN
HL1032 more like this
HL1033 more like this
HL1034 more like this
HL1036 more like this
HL1042 more like this
star this property question first answered
less than 2015-07-14T15:00:42.073Zmore like thismore than 2015-07-14T15:00:42.073Z
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property attachment
1
star this property file name colbalamin and folate disorders.pdf more like this
star this property title BSCH Guidance more like this
star this property tabling member
1861
star this property label Biography information for The Countess of Mar more like this
386927
star this property registered interest false more like this
star this property date remove filter
star this property answering body
Department of Health more like this
star this property answering dept id 17 more like this
star this property answering dept short name Health more like this
star this property answering dept sort name Health more like this
unstar this property hansard heading Vitamin B12 more like this
star this property house id 2 more like this
star this property legislature
25277
star this property pref label House of Lords more like this
star this property question text To ask Her Majesty’s Government whether they have assessed the social and economic costs of misdiagnosis or late diagnosis of pernicious anaemia and other vitamin B12 deficiencies; and, if so, what they consider them to be. more like this
star this property tabling member printed
The Countess of Mar more like this
star this property uin HL1036 more like this
star this property answer
answer
unstar this property is ministerial correction false more like this
star this property date of answer less than 2015-07-14more like thismore than 2015-07-14
star this property answer text <p>The diagnosis and treatment of pernicious anaemia, the result of a vitamin B12 (cobalamin) deficiency, is well established and reported in the British Committee for Standards in Haematology (BCSH) guidance document, <em>Guidelines for the diagnosis and treatment of Cobalamin and Folate disorders</em>, which was updated in May 2014. A copy of the BCSH guidance document is attached.</p><p> </p><p>The BCSH operates independently of the Department and NHS England and produces evidence based guidelines for both clinical and laboratory haematologists on the diagnosis and treatment of haematological disease, drawing on the advice of expert consultants and clinical scientists practicing in the United Kingdom. It would be for the BCSH, not the Department, to consider whether any adjustments to current best practice, in the diagnosis and treatment of patients with pernicious anaemia were needed, including whether any new or additional tests were appropriate.</p><p> </p><p> </p><p> </p><p>The BCSH guidance sets out that cobalamin status is the recommended first line diagnostic test. The Department has no data relating to false positive results in relation to the test. The guidance also states that clinical picture is the most important factor in assessing the significance of the test results.</p><p> </p><p> </p><p> </p><p>When anaemia is diagnosed, most patients respond well to treatment through quarterly intramuscular injection of vitamin B12. Whilst some patients with pernicious anaemia might prefer to have more frequent injections, or for other forms of vitamin B12 to be self-administered, these are matters for individual patients to discuss with their general practitioners.</p><p> </p><p> </p><p> </p><p>Although the Medicines Healthcare products Regulatory Agency is currently reviewing claims made by some clinics that are administering vitamins and minerals intravenously for nutritional therapy purposes, the agency has not encountered any clinics making claims to treat pernicious anaemia. In addition, the Department does not have any information regarding patients purchasing additional supplies of B12 from unregulated sources.</p><p> </p><p> </p><p> </p><p>Regarding the mandatory fortification of flour with folic acid, the Scientific Advisory Committee on Nutrition recommended a number of measures to ensure monitoring and surveillance of the impact of fortification of flour, should it be implemented. This included appropriate systems to monitor any potential adverse effects, including cancer and a review of the evidence on benefits and postulated risks after five years. The National Diet and Nutrition Survey monitors folate intakes and the most recent data, which was published earlier this year, will be carefully considered alongside other information sources before any decision is made on mandatory fortification.</p><p> </p><p> </p><p> </p><p>The Department has made no assessment of the social and economic costs of misdiagnosis or late diagnosis of pernicious anaemia and other vitamin B12 deficiencies.</p><p> </p>
star this property answering member printed Lord Prior of Brampton more like this
star this property grouped question UIN
HL1032 more like this
HL1033 more like this
HL1034 more like this
HL1035 more like this
HL1042 more like this
star this property question first answered
less than 2015-07-14T15:00:42.183Zmore like thismore than 2015-07-14T15:00:42.183Z
star this property answering member
127
star this property label Biography information for Lord Prior of Brampton more like this
star this property attachment
1
star this property file name colbalamin and folate disorders.pdf more like this
star this property title BSCH Guidance more like this
star this property tabling member
1861
star this property label Biography information for The Countess of Mar more like this