The Scottish Medicines Consortium has announced that edoxaban (Lixiana) will be available to Scottish patients to treat venous thromboembolism (VTE), which covers both pulmonary embolism (PE) and deep vein thrombosis (DVT).
Edoxaban is a Non-VKA Oral Anti-Coagulants (NOACs) used to treat non-valvular atrial fibrillation (NVAF). It is used as an alternative to warfarin, which has been widely used for over 50 years but requires frequent monitoring to ensure it is working properly. Warfarin is also associated with many food and drug interactions.
Professor John McMurray, Professor of Cardiology at Glasgow University, who has researched AF in Scotland, said edoxaban gave doctors the ability to better tailor medicines to individual patients.
“Until recently, all we had to prevent strokes in AF patients was warfarin, which imposed certain lifestyle restrictions on patients and needed regular monitoring with a blood test known as the INR. Now we are spoilt for choice with modern blood-thinning drugs that do not need INR monitoring and are easier for patients to live with.”
In the NVAF guidance the SMC stated: “Edoxaban is accepted for use within NHS Scotland for prevention of stroke and systemic embolism in adult patients with non-valvular atrial fibrillation (NVAF) with one or more risk factors, such as congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke or transient ischaemic attack (TIA).
“Many patients are on warfarin which needs to be dose adjusted dependent on the INR blood levels which require regular monitoring. It also interacts with many foods and medicines. Edoxaban would provide patients with another oral anticoagulation option which may impact positively on their day to day, social and working lives as it is a once daily dose and does not require any regular monitoring. In addition, it does not need significant adjustments to diet and lifestyle.”
For VTE the SMC stated: “Edoxaban is accepted for use within NHS Scotland for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and prevention of recurrent DVT and PE in adults.”
Non-valvular atrial fibrillation (NVAF) is a condition where the heart beats irregularly meaning blood can pool and thicken in the chambers of the heart, causing a risk of clots which then go on to cause strokes. Patients with AF are five times more likely to suffer a stroke than those without the condition.4 Recent figures suggest there are some 96,000 people in Scotland with AF, with a prevalence of 1.8% of the population.
Venous thromboembolism (VTE) is a condition in which a blood clot (a thrombus) forms in a vein, most commonly in the deep veins of the legs or pelvis. This is known as deep vein thrombosis, or DVT. The thrombus can dislodge and travel in the blood (an embolus), particularly to the pulmonary (lung) arteries. This is known as pulmonary embolism, or PE. The term VTE includes both DVT and PE.