Rivaroxaban in atrial fibrillation

15th June 2012 by Louise Hudman

This guideline is for Rivaroxaban, which is a Factor Xa inhibitor and has been approved for use in patients with nonvalvular AF and at least one of the following risk factors (which equates to a CHADS2 score of at least 1):

  • CHF
  • Hypertension
  • 75 or older
  • Diabetes
  • CVA or TIA

It is very expensive, but it’s main bonus is that no monitoring is needed. It has a similar safety profile to warfarin (it seems to cause more GI bleeds, but fewer intracranial bleeds – though only in those who’ve previously had warfarin). It is not inferior in effectiveness to warfarin. The study wasn’t good enough to compare it to dagabatrin.

The advice from NICE is to discuss the pros and cons with the patient. Those most likely to benefit are those whose INR is not well controlled. The trial didn’t show much for people with CHADS2 score of 1, so they may get less benefit.

Join

Join to view the rest of this content, as well as access all the benefits of joining NASGP.

Join

Login

Already a member? Login to view this content.

Login

"We have used LocumDeck for a number of months now and find it really useful when booking locums. You can see the availability of GPs, their documents are all loaded on the site and you can book instantly – it takes minutes to do. There are also no expensive locum agency fees to pay – just the GP’s actual payment. It's quick and hassle-free."

Lesley Munro-Faure, Managing Partner at Unity Health, York

See the full list of features within our NASGP membership plans

Membership