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NICE recommends Bayer heart attack drug

Published on 26/01/15 at 11:48am
Xarelto image

NICE has recommended Xarelto in final draft guidance as an option for preventing blood clots in people who have had an acute coronary syndrome (ACS).

Xarelto (rivaroxaban) from Bayer is a treatment for ACS, or heart attack where one or more of the blood vessels in the heart become narrowed or blocked.

The oral blood-thinning pill has gone on to become a big earner for the German pharma firm to date, with fourth-quarter US sales of Xarelto nearly doubling from $864m in 2013 to $1.5 billion last year.

The new guidance now recommends the drug in combination with clopidogrel and aspirin in patients who have a severe ACS, and that shows how heart muscle has been damaged.

Xarelto prevents the formation of blood clots by stopping a substance called Factor Xa from working, which is necessary in the formation of thrombin and fibrin, the key components in blood clot development.

According to Professor Carole Longson, who is the health technology evaluation centre director at NICE, the pill does display a higher risk of causing bleeding. “Because of this risk, the draft guidance recommends that before starting treatment doctors should carry out a careful assessment of a person’s bleeding risk.”

Longson continues: “The decision to start treatment should be made after an informed discussion between the doctor and patient about the benefits and risks of rivaroxaban. Also, because there is limited experience of treatment with rivaroxaban up to 24 months, the draft guidance recommends careful consideration should be given to whether treatment is continued beyond 12 months.”

The oral blood-thinning drug is produced in collaboration with Johnson & Johnson and contributed to the company’s 10% increase in worldwide sales of its overall drugs in the last quarter of 2014.

People who have a heart attack are at higher risk of having further events according to NICE. In 2009/10 there were 57,000 admissions for heart attacks in England, with 28,000 subsequent artery problems.

Aside from treating patients who have had an ACS, Xarelto also reduces atrial fibrillation stroke risk, plus is clinically proven to reduce the threat of deep vein thrombosis and pulmonary embolism.

Tom Robinson

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