Dr John Walsh has no conflict of interests to declare. Dr Ed Wilkins has received lecture and consultancy fees from Abbott, Bristol-Myers Squibb, Gilead, Janssen, Merck Sharp and Dohme and Pfizer. Dr Alan Winston has received lecture fees from Janssen and his department has received research grants from Abbott, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead, GlaxoSmithKline, Janssen, Pfizer, Roche and ViiV. Dr Mike Youle has received lecture and consultancy fees from Abbott

and Gilead. “
“BHIVA revised and updated the Association’s guideline development manual Regorafenib nmr in 2011 [1]. BHIVA has adopted the modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) system for the assessment, evaluation and grading of evidence and the development of recommendations [2,3]. 1A Strong recommendation. High-quality evidence. Benefits clearly outweigh risk and burdens, or vice versa. Consistent evidence from well-performed, randomized, controlled trials or overwhelming evidence of some other form. Further research is unlikely to change our confidence in the estimate of benefit and risk. Strong recommendations, can apply to most patients

in most circumstances without reservation. Clinicians should follow a strong recommendation ABT-737 nmr unless there is a clear rationale for an alternative approach. 1B Strong recommendation. Moderate-quality evidence. Benefits clearly outweigh risk and burdens, or vice versa. Evidence from randomized, controlled trials with important limitations (inconsistent results, methods flaws, indirect or imprecise), or very strong evidence of some other research design. Further research may impact on our confidence in the estimate of benefit and risk. Strong recommendation

and applies to most patients. Clinicians should follow a strong recommendation unless a clear and compelling rationale for an alternative Histamine H2 receptor approach is present. 1C Strong recommendation. Low-quality evidence. Benefits appear to outweigh risk and burdens, or vice versa. Evidence from observational studies, unsystematic clinical experience, or from randomized, controlled trials with serious flaws. Any estimate of effect is uncertain. Strong recommendation, and applies to most patients. Some of the evidence base supporting the recommendation is, however, of low quality. 1D Strong recommendation. Very low-quality evidence. Benefits appear to outweigh risk and burdens, or vice versa. Evidence limited to case studies. Strong recommendation based mainly on case studies and expert judgement. 2A Weak recommendation. High-quality evidence. Benefits closely balanced with risks and burdens. Consistent evidence from well-performed randomized, controlled trials or overwhelming evidence of some other form. Further research is unlikely to change our confidence in the estimate of benefit and risk.