NICE drafts final guidance on stroke-prevention treatment

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NICE has issued guidance that recommends new treatment for people with common heart conditions to reduce risk of strokes.

In final draft guidance published today NICE has recommended a treatment called Apixaban for the prevention of stroke and systemic embolism in some people.

It also stated that the decision about whether to start Apixaban treatment should be made after an informed discussion about the risks and benefits compared with other treatment types.

Atrial fibrillation (AF), NICE uses as an example, is the most common cardiac arrhythmia (irregular heart beat) and sufferers are at higher risk of developing blood clots and subsequent stroke which can be "substantially reduced" by appropriate use of other treatment methods.

Apixaban recieved its license in November 2012; it is an orally administered anticoagulant that helps to prevent blood from clotting.

It has UK marketing authorisation for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation and one or more risk factors including; an age of 75 or over; hypertension; diabetes mellitus; or symptomatic heart failure.

Professor Carole Longson, director of NICE Health Technology Evaluation Centre, said: "Atrial fibrillation can be a distressing condition and people with it have an increased risk of suffering a stroke.

"Many people with the condition find it difficult to comply with the most commonly used treatment called warfarin, because, among other things, its use requires regular monitoring of the blood's clotting properties and dose adjustments which can cause disruption and inconvenience.

"The Appraisal Committee heard from patient experts that warfarin can have a greater impact on a person's quality of life than atrial fibrillation itself."

NICE has not issued final guidance to the NHS yet and registered consultees can appeal the draft guidance.
NHS bodies will make decisions locally on the funding of specific treatments until NICE issues final guidance.

Local recommendations across the country will be replaced once NICE issues its final guidance likely to be published in February 2013.

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