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NICE approves new oral anti-coagulant for atrial fibrillation

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The drug edoxaban has been given the official seal of approval for NHS use in preventing stroke and blood clots in patients with a common heart disorder.

Official guidance, published this week, has recommended the oral anti-coagulant as an option for treating those with non-valvular atrial fibrillation (NVAF), who are also affected by factors that increase their risk of having a stroke or suffering potentially fatal clotting.

“Because edoxaban doesn’t require frequent blood tests to monitor treatment it represents a significant potential benefit for many people with NVAF”

Carole Longson

The heart rhythm disorder NVAF affects at least 800,000 people in the UK with symptoms including palpitations, dizziness and shortness of breath.

Factors that can increase risk of stroke and blood clots include hypertension, diabetes, being over 75 and already having had a stroke or mini-stroke in the past.

Final guidelines, published by the National Institute for Health and Care Excellence, confirmed edoxaban (Lixiana) was a suitable treatment option for this patient group.

Previously people with NVAF and risk factors for stroke and blood clots were often given warfarin, although increasingly newer oral anti-clotting drugs – such as dabigatran, rivaroxaban and apixaban – are being prescribed.

The new guidance means clinicians can now add edoxaban to this range of options, which could have significant benefits for some patients.

“Many people with NVAF find taking warfarin difficult because it requires monitoring and dose adjustments and can interact with many foods and other drugs,” said Professor Carole Longson, director of NICE’s health technology evaluation centre.

“Because edoxaban, like the other newer agents, doesn’t require frequent blood tests to monitor treatment it represents a significant potential benefit for many people with NVAF,” she said.

The guidance noted that any decision to switch to edoxaban should only be made after a frank discussion between clinician and patient, which would clearly set out the risks and benefits of the drug compared to warfarin and other options.

Edoxaban, manufactured by Daiichi Sankyo, costs £58.80 for a 28-tablet pack (60mg or 30mg) and the daily cost of treatment is £2.10 (excluding VAT).

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