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Oral anticoagulant Xarelto ( Rivaroxaban ) has been recommended for National Health Service ( NHS ) use in Final Guidance by the United Kingdom’s National Institute for Health and Clinical Excellence ( NICE ) as a single-drug therapy for the treatment of deep vein thrombosis ( DVT ) and the prevention of recurrent DVT and pulmonary embolism ( PE ) following an acute deep vein thrombosis in adults.
In May this year NICE already recommended Xarelto for NHS use for the prevention of stroke and non-CNS systemic embolism in eligible adult patients with non-valvular atrial fibrillation.

The announcement comes shortly after NICE published its Clinical Guidelines on the management of venous thromboembolism ( VTE ), which recognise that the failure to adequately detect and treat VTE can result in devastating patient outcomes, including death.

With the publication of guidance for Rivaroxaban, DVT patients can now be treated with a single drug, rather than the existing dual-drug approach of low molecular weight heparin ( LMWH ) administered by injection, followed by a vitamin K antagonist ( VKA ) such as Warfarin.
The Appraisal Committee acknowledged the limitations of the current dual-drug regimen and recognised the advantages of Rivaroxaban in removing the need for routine INR monitoring and for its convenient oral formulation.

The decision by NICE followed an assessment of both the clinical and cost-effectiveness benefits of Rivaroxaban, drawing on the multinational, randomized, event-driven EINSTEIN-DVT and EINSTEIN-EXT studies.

Source: Bayer, 2012

XagenaMedicine2012