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Southampton Health Technology Assessments CentreNews

NICE guidance informed by SHTAC report on rivaroxaban for preventing major cardiovascular events in people with coronary or peripheral artery disease

Published: 17 October 2019
Heart image
Coronary and peripheral arterial disease is a common condition

The National Institute for Health and Care Excellence (NICE) has issued guidance to the National Health Service (NHS) on the use of the Rivaroxaban plus aspirin, for preventing atherothrombotic events, informed by a report produced by SHTAC. NICE’s guidance recommends Rivaroxaban (Xarelto) with aspirin within its marketing authorisation as a possible treatment for preventing atherothrombotic events (such as stroke or heart attack) in adults who are at high risk because they have:

  • peripheral artery disease or
  • coronary artery disease and they:

are 65 or older, or
have atherosclerosis (fatty deposits) in at least 2 arteries, or
have at least 2 extra risk factors such as smoking, diabetes, certain types of kidney problem, heart failure, or they’ve had a type of stroke called a non-lacunar ischaemic stroke.

A person's risk of bleeding should be assessed before considering rivaroxaban. Treatment should only be started after an informed discussion 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.

NICE’s guidance is informed by an evidence review group report prepared by SHTAC, which critically appraised the drug company’s submission to NICE’s Single Technology Appraisal process.

For more information about SHTAC’s previous research into cardiovascular conditions please visit our Research page.

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