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Agilio: Diagnosis and Treatment Guidance October 2025 Update

This update contains 7 significant changes and 13 minor changes.

Significant changes:

  • Acute Childhood Limp — reviewed. A literature search was conducted in August 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. No major changes to recommendations have been made.
  • Addison’s disease — reviewed. A literature search was conducted in August 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. Recommendations from the NICE guideline Adrenal insufficiency: identification and management have been incorporated into this topic.
  • Baker’s cyst — reviewed. A literature search was conducted in June 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. No major changes to recommendations have been made.
  • Constipation in children — reviewed. A literature search was conducted in August 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. No changes have been made to the recommendations.
  • Glaucoma — reviewed. A literature search was conducted in July 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic.
  • Multiple myeloma — reviewed. A literature search was conducted in July 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. No major changes to the recommendations have been made.
  • Tiredness/fatigue in adults — reviewed. A literature search was conducted in March 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. Recommendations have been updated in line with current evidence in the literature. Text regarding the diagnosis and management of suspected or confirmed myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) has been removed and links to a new Prodigy topic on Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) have been written.

 

Minor changes:

  • Bipolar — minor update. Timing of post-dose lithium updated to 10-14 hours in line with Maudsley Prescribing guidance, 2025. Wording surrounding the use of contraception for men and boys on valporate has been updated to be more in line with NICE guidance.
  • Cellulitis — minor update. Doxycycline has been added as a first-line alternative for people allergic to penicillin in line with the updated BLS/LSN Guidelines on the management of cellulitis in lymphoedema.
  • Cervical Screening — minor update. Revised screening interval to 5 years for women aged 25-49 years in line with the National Screening Programme.
  • Cough – acute with chest signs in children — minor update. Management of community aquired pneumonia updated in line with NICE, 2025.
  • COVID 19 — minor update. Updated with vaccines available for autumn 2025.
  • Erectile dysfunction — minor update. Minor typographical error corrected.
  • Giant cell arthritis — minor update. A duplicated section of text has been removed.
  • Heart failure — minor update. Recommendations have been aligned to the updated NICE, 2025 guideline Chronic heart failure in adults: diagnosis and management. Prescribing sections have been added for mineralocorticoid receptor antagonists (MRAs) and angiotensin receptor-neprilysin inhibitors (ARNIs), angiotensin-converting enzyme (ACE) inhibitors, and angiotensin II receptor blockers (ARBs) have also been updated and aligned with the NICE guideline.
  • Hypertension — minor update. The sections on monitoring abnormal results for people taking a renin-angiotensin system antagonist have been updated in line with the recommendations in the NICE guideline Chronic heart failure in adults: diagnosis and management.
  • Lipid modification – CVD prevention — minor update. Typographical error corrected.
  • Migraine — minor update. Added prescribing section for candesartan.
  • Obesity — minor update. A typographical error has been corrected.
  • Scabies — minor update. Revised wording on prescribing a second dose of ivermectin after 7 days to enhance effectiveness.
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