New blood thinning agent approved for GPs in Scotland

Rivaroxaban for DVT and for stroke prevention in AF has been approved by the Scottish Medicines Consortium (SMC), widening treatment options for GPs in Scotland.

DVT: The thrombus (abnormal clot, white) is blocking the flow of blood (red) in the vein (Photograph: SPL)
DVT: The thrombus (abnormal clot, white) is blocking the flow of blood (red) in the vein (Photograph: SPL)

Marketed as Xarelto by Bayer and licenced in the UK, rivaroxaban works by blocking Factor Xa, a blood clotting agent.

The SMC accepted rivaroxaban for the treatment for DVT and prevention of recurrent DVT and pulmonary embolism following acute DVT in adults.

It also accepted the anticoagulant for limited use in the prevention of stroke and systemic embolism in adults with non-valvular AF and at least one risk factor. Use is restricted to patients who have poor INR control despite compliance with coumarin anticoagulant, and to patients who are allergic to or unable to tolerate coumarin anticoagulants.

Evidence considered by the consortium found rivaroxaban worked as well as standard therapy, but showed additional bleeding against placebo. SMC said it approved the drug because it offers 'value for money'.

The drug was previously accepted by SMC for prevention of venous thromboembolism in adults who undergo hip and knee surgery in 2008.

NICE is also considering rivaroxaban for preventing stroke and systemic embolism in AF. But it held back from recommending the drug in draft guidance issued in January.

The institute said the relative effectiveness of rivaroxaban compared with warfarin had been 'overestimated' for the UK population, and called on Bayer to submit further evidence.

NICE will issue its final guidance by May.

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