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NICE gives early backing to drug to prevent and treat blood clots

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The National Institute for Health and Care Excellence has provisionally recommended the drug apixaban (Eliquis) as an option for treating and preventing venous thromboembolism in adults.

NICE has today issued draft guidance on the oral anti-blood clotting treatment apixaban, which is manufactured by Bristol-Myers Squibb and Pfizer.

It helps to prevent blood from clotting by stopping a substance called Factor Xa from working. Factor Xa is necessary in the formation of thrombin and fibrin, key components in blood clot formation.

Professor Carole Longson, director of the NICE Health Technology Evaluation Centre, said: “For many people, using warfarin can be difficult because of the need for frequent tests to see if the blood is clotting properly, and having to adjust the dose of the drug if it is not.

“Apixaban, like the other newer oral anticoagulants already recommended by NICE for the treatment and secondary prevention of VTE, does not require frequent blood tests to monitor treatment and so represents a potential benefit for many people who have had a VTE,” she said, launching a consultation on the draft guidance.

Professor Longson also said NICE had been told that apixaban was the only oral anticoagulant for which the licensed dose was lower for secondary prevention than for initial treatment of VTE.

“This could also be of potential benefit in terms of reducing the risk of bleeding where treatment is continued and, therefore, increase the chance that a person would take apixaban long term,” she said.

According to prescribing information, 10mg apixaban should be taken twice a day for the first seven days, followed by 5mg twice a day for at least three months. For the prevention of recurrent events, people who have completed six months of treatment should take 2.5mg twice a day.

The cost of apixaban is £1.10 per tablet for either the 2.5mg or 5mg dose (excluding VAT). The daily cost of apixaban is £2.20.

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