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A blood-thinning drug has been given the go-ahead for use on the NHS in a move that is expected to revolutionise stroke prevention.
The drug – the first anti-clotting agent to be developed in almost 60 years – could eventually replace warfarin, the most commonly used therapy, which is based on rat poison.
Almost a million patients suffering an irregular heartbeat could be eligible to take the new drug, called Pradaxa, which could prevent an additional 5,000 strokes a year.
Warfarin is used by more than 500,000 patients in the UK. But users need close monitoring and regular blood tests to prevent potential excessive bleeding from cuts or stomach ulcers.
Warfarin can also interact badly with other drugs and some foods including green vegetables and grapefruit, while alcohol can affect its action.
Pradaxa, also known as dabigatran, works as well as warfarin, while a higher daily dose, of 300mg a day, is almost one-third more effective at reducing the risk of stroke.
Patients taking the capsules do not have to be constantly checked, can eat what they like and it is much easier to use with other medicines.
Pradaxa costs £2.50 a day – vastly more than about £1 for a month’s supply of warfarin – and patients have to take it for life.
But NHS rationing body the National Institute for Health and Clinical Excellence (Nice) has deemed it to be cost-effective and approved its use in England and Wales, despite warnings from some NHS managers that it could bust their budgets.
It is estimated that high-dose Pradaxa in up to 900,000 eligible patients – many of whom are at risk but currently untreated – could prevent an extra 5,000 strokes a year, saving the NHS up to £59million in the first year.
NHS Salford attempted to block approval, arguing it would have the ‘biggest impact to date’ of any Nice decision, as it would be taken up by hundreds of thousands of patients.
The drug is one of a new generation of anti-clotting agents aimed at preventing strokes and other potentially fatal problems in people suffering atrial fibrillation (AF).
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| Research published by the Royal Brompton Hospital suggests the new pill could benefit those unable to use current medication |
In AF the upper chambers of the heart are out of rhythm and beat much faster than normal, which allows blood to pool and generate tiny blood clots which can trigger a stroke.
Doctors claim Pradaxa could trigger an overdue shake-up in stroke prevention.
Professor Martin Cowie, professor of cardiology at Royal Brompton Hospital, London, has published research suggesting one in three people with AF get no treatment at all, while others get ‘inadequate’ treatment with aspirin.
He added: ‘Some patients have been stable on warfarin for years, they won’t necessarily need to change, but others are untreated, under-treated or can’t tolerate warfarin.’
The drug, by Boehringer Ingelheim, is licensed for AF patients after a previous stroke or transient ischaemic attack – a ‘mini-stroke’ – and in those aged 65 or older with diabetes, hypertension or cardiovascular disease.
Trudie Lobban, of the Atrial Fibrillation Association, said: ‘Consequences of blood clots can be overwhelming and their prevention and treatment should rightly be considered a health priority.
‘There are a million AF sufferers in England, but less than 50 per cent are currently receiving therapy. With the new anti-coagulant, which is easier to manage, far more will now have access to appropriate treatment.’
http://www.dailymail.co.uk/health/article-2115136/New-blood-thinning-drug-stop-5-000-strokes-year.html
