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Rivaroxaban (Xarelto®▼): NICE TA607

Guidance1

1.1 Rivaroxaban plus aspirin is recommended within its marketing authorisation, as an option for preventing atherothrombotic events in adults with coronary artery disease or symptomatic peripheral artery disease who are at high risk of ischaemic events.

1.2 For people with coronary artery disease, high risk of ischaemic events is defined as:

  • aged 65 or over, or
  • atherosclerosis in at least 2 vascular territories (such as coronary, cerebrovascular, or peripheral arteries), or
  • 2 or more of the following risk factors:
    • current smoking
    • diabetes
    • kidney dysfunction with an estimated glomerular filtration rate (eGFR) of less than 60 ml/min (note that rivaroxaban is contraindicated if the eGFR is less than 15 ml/min)
    • heart failure
    • previous non-lacunar ischaemic stroke.

1.3 Assess the person’s risk of bleeding before considering rivaroxaban. Treatment should only be started after an informed discussion with them about the risks and benefits of rivaroxaban, weighing up the risk of atherothrombotic events against the risk of bleeding. The risks and benefits of continuing treatment with rivaroxaban should be regularly reviewed.

Aim of technology appraisals

NICE is asked by the Department of Health to appraise the health benefits and costs of new and existing drugs and other technologies and make recommendations to the NHS in England and Wales. Technologies are referred to NICE when they have the potential for significant health benefits, an impact on resources, and/or where there may be variation or uncertainty in the use of the technology across the country.

Reference

  1. NICE. Rivaroxaban for preventing atherothrombotic events in people with coronary or peripheral artery disease. NICE Technology Appraisal Guidance 607. NICE, October 2019. www.nice.org.uk/ta607

 

When NICE recommends a treatment, the NHS must make sure it is available to those people it could help, normally within 3 months of the guidance being issued. 

The production and printing of this Guidelines summary card has been commissioned by Bayer plc. Bayer plc has reviewed the card for technical accuracy and regulatory compliance and supplied the prescribing information.
This summary card only displays the concise guidance; readers are strongly advised to refer to the full guidance at www.nice.org.uk/ta607
©NICE 2019. Technology Appraisal 607. Rivaroxaban for preventing atherothrombotic events in people with coronary or peripheral artery disease. Available from www.nice.org.uk/ta607 All rights reserved. Subject to notice of rights.
NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this publication.
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RP-XAR-GB-1114

Date of preparation: October 2019

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