New anticoagulant approved by NICE

GPs have been handed another alternative to warfarin after NICE gave preliminary approval to a new treatment to prevent stroke in AF.

Apixaban avoids the regular INR checks and dose adjustments required on warfarin treatment
Apixaban avoids the regular INR checks and dose adjustments required on warfarin treatment

The oral anticoagulant apixaban (Eliquis) was accepted by NICE for preventing stroke and systemic embolism in non-valvular AF in final draft guidance.

If approved in final guidance next month, it will join dabigatran etexilate and rivaroxaban as NICE-backed alternatives to warfarin treatment in patients with AF.

NICE said apixaban is more effective than warfarin and removes the need for regular INR checks and dose adjustments. Apixaban also causes fewer bleeds than warfarin, it said.

The treatment costs £803 a year per patient and would be a cost-effective use of NHS funds, NICE said.

Before initiating treatment, doctors should discuss with patients the risks and benefits of apixaban compared with other anticoagulants, the institute said. Current INR control among those on warfarin should also be considered.

Professor Carole Longson, director of NICE's Health Technology Evaluation Centre, said: 'The appraisal committee heard from patient experts that warfarin can have a greater impact on a person’s quality of life than AF itself.

'Apixaban, like rivaroxaban and dabigatran etexilate, which NICE recently approved as options for this indication, has potential benefits for people with AF in these circumstances because it doesn’t require such regular monitoring and dose adjustments.'

More than a fifth of the 130,000 strokes in England and Wales each year are caused by AF.

NICE will make its final decision in February.

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