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NICE backs drug to reduce stroke risk for AF patients

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The National Institute for Clinical Excellence is now recommending the use of apixaban for some patients with irregular heartbeats to help prevent them experiencing stroke or systemic embolism.

New final draft guidance states the orally-administered anticoagulant is now a recommended treatment for non-valvular atrial fibrillation (AF) - the most common type of cardiac arrhythmia.

But the organisation urged health professionals to make sure those they are treating know about the pros and cons of apixaban when compared with other drugs including warfarin, rivaroxaban and dabigatran etexilate. The National Institute of Clinical Excellence (NICE)’s draft guidance also states that if a patient is already taking warfarin then their level of international normalised ratioi (INR) control should be taken into account before deciding whether to treat them with apixiban.

Patients with AF are more likely to develop blood clots, which can then lead to stroke. Apixaban, which helps stop blood from clotting was first licensed to help prevent strokes in people with AF two months ago.

Professor Carole Longson, NICE health technology evaluation centre director, said the committee had studied the evidence and come to the conclusion that apixaban was a better treatment than warfarin for the purpose of lowering the risk of stroke and systemic embolism. It also found patients were less likely to suffer from intracranial bleeding while taking apixaban than if they had been prescribed warfarin.

She said NICE recognised the importance of reducing the likelihood of this type of bleeding as it has a high mortality rate and is a complication a lot of patients worry about.

NICE still has to issue its final guidance to the NHS on the matter.

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