NICE draft guidance recommends Eliquis for treating and preventing potentially fatal blood clots

In draft guidance published today, the National Institute for Health and care Excellence (NICE), the medical costs watchdog for England, has recommended the anti-blood clotting drug Eliquis (apixaban), from US pharma majors Bristol-Myers Squibb (NYSE: BMY) and Pfizer (NYSE: PFE) as a National Health Service option for treating and preventing venous thromboembolism (VTE) in adults.

Deep vein thrombosis (DVT) can result in long-term illness, including venous ulceration and chronic pain, swelling and skin changes in the affected limb which can have a significant impact on quality of life. Risk factors for VTE include a history of DVT, recent surgery, immobility, active cancer or cancer treatment, being aged over 60 years, obesity, hormone replacement therapy or estrogen containing contraceptive therapy and having other conditions such as heart disease.

People with suspected DVT or PE are generally treated immediately with drugs that help to prevent the blood from clotting (anticoagulants), most commonly with injections of low molecular weight heparin. When the diagnosis has been confirmed, this is overlapped with warfarin, or treatment may be switched to one of the other newer oral anticoagulants (such as apixaban, rivaroxaban or dabigatran). Both apixaban and rivaroxaban can be used from the start and do not have to be preceded by heparin. Dabigatran is initiated after at least five days treatment with an injectable anticoagulant such as low molecular weight heparin.