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British Journal of Cardiology

Clinical Articles, News & Views

NOAC news

The National Institute for Health and Care Excellence (NICE) has issued Final Appraisal Determination (FAD) recommending the NOAC (non-vitamin K oral anticoagulant) apixaban (Eliquis®) as an option for the treatment and prevention of recurrent deep vein thrombosis (DVT) and/or pulmonary embolism (PE) in adults.

The Appraisal Committee concluded that apixaban could be considered a clinically and cost-effective use of NHS resources and recommended the drug, within its marketing authorisation. The NICE FAD recommendation for apixaban, whose licensed dose is lower for the prevention of recurrent DVT and PE than for initial treatment of DVT and PE, provides clinicians with an additional oral single-drug option without the need for injectable therapy or routine monitoring of exposure.

The Scottish Medicines Consortium (SMC) has also announced that they have accepted apixaban for use within NHS Scotland.


The European Committee for Medicinal Products for Human Use (CHMP) has recommended approval of the NOAC edoxaban (Lixiana®) for the prevention of stroke and systemic embolism (SE) in adult patients with non-valvular atrial fibrillation (NVAF) with one or more risk factors. The CHMP also recommended approval of edoxaban for the treatment of DVT and PE, and prevention of recurrent DVT and PE in adults.


Results from the VENTURE-AF trial were presented recently at the Heart Rhythm Society’s 36th Annual Scientific Sessions, in Boston, USA, and published simultaneously in the European Heart Journal (doi: 10.1093/eurheartj/ehv177).

In this study, the NOAC rivaroxaban (Xarelto®) was investigated as an alternative to dose-adjusted vitamin K antagonists (VKAs) to reduce the risk of stroke and SE in patients with NVAF undergoing catheter ablation.

Patients with AF scheduled for catheter ablation were randomly assigned in a 1:1 ratio to rivaroxaban 20 mg orally once-daily or to dose-adjusted VKA (target INR 2.0–3.0). In patients treated with rivaroxaban, there were no thromboembolic events. In those patients receiving a VKA, two thromboembolic events occurred. There was one major bleeding event in the VKA treatment arm versus none in the rivaroxaban arm. No major bleeding events occurred in either group and the incidence of non-major bleeding events and procedure-attributable events was low for both treatment arms.

Published on: May 28, 2015

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association

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