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.

Read more

No credit card details needed – it takes two minutes.

Join free trial

Login

Already a member? Login to view this content.

Login

"LocumDeck does everything you want it to do in an instant. I absolutely love the facility for receiving locums' invoices and the facility for signing pension forms electronically. They are then instantly sent with an audit trail. It is fabulous! You are notified the moment a GP locum adds availability, which is just fantastic. I have no hesitation in recommending LocumDeck – it has already eased my workload."

Sue, practice manager, Portsmouth

See the full list of features within our NASGP membership plans

Membership