NICE recommends apixaban for stroke prevention in AF

New guidance from NICE recommends the use of apixaban (Eliquis) as an option for preventing stroke and systemic embolism in patients with non-valvular atrial fibrillation.

The licensed dose is 5mg twice daily but this is reduced to 2.5mg twice daily in certain situations | SCIENCE PHOTO LIBRARY
The licensed dose is 5mg twice daily but this is reduced to 2.5mg twice daily in certain situations | SCIENCE PHOTO LIBRARY

Use of apixiban is restricted to patients with one or more risk factors for stroke or systemic embolism, including:

  • prior stroke or transient ischaemic attack
  • age ≥75 years
  • hypertension
  • diabetes mellitus
  • symptomatic heart failure.

Initiation

The decision to start treatment with apixaban should be based on a risk to benefit analysis of the oral factor Xa inhibitor compared with warfarin, dabigatran and rivaroxaban. In patients currently receiving warfarin, the existing level of INR control should be taken into account. 

NICE guidance on apixaban for stroke prevention in AF

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