Tuesday, October 30, 2012

MTRAC Committe recommends Rivaroxaban and Dabigatran in patients on warfarin with unacceptable TTR


MTRAC, the Midlands Therapeutics Review & Advisory Committee, has issued commissioning guidance on rivaroxaban (XareltoR) for stroke prevention in patients with non-valvular atrial fibrillation (AF).

The committee recommends that warfarin remains a first-line option for anticoagulation in patients with AF at high risk of a stroke. Rivaroxaban is considered suitable for prescribing in primary care as an option (after discussion with the patient) for anticoagulation in patients with AF at high risk of a stroke, and NICE recommendations are discussed.

Rivaroxaban may be most suitable for:

- those patients with co-morbidities who are adherent to warfarin monitoring and lifestyle requirements but need frequent co-prescribed medications that interact with warfarin and affect the patients' time in the therapeutic range (TTR)

- those patients who are adherent to monitoring and lifestyle requirements but whose TTR remains unacceptable despite attempts to optimise treatment with warfarin


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