NICE guidance – updates

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Guidance by topic: the following guidance topics matching your health area preferences have been published or updated


Journal of Clinical Pharmacy and Therapeutics; Yates J.; Choudhry M.; Keys G; April 2013

A case report describing a suspected rivaroxaban hypersensitivity reaction in a surgical patient was published in April 2013, vol./is. 38/2(159-161), 0269-4727;1365-2710

Abstract:    Rivaroxaban is an oral anticoagulant, currently licensed for use as a venous thromboembolism (VTE) prophylaxis, and recommended by the National Institute for Clinical Excellence (NICE) for all patients undergoing elective hip and knee replacement surgery in the UK. We present the first case of a suspected hypersensitivity to rivaroxaban.

Case summary: A 57-year-old man with no previous allergies underwent an uncomplicated, elective partial knee replacement, after which he was prescribed a routine 2-week course of rivaroxaban 10 mg. He developed an allergic response requiring readmission for assessment and treatment 7 days post-operatively.

Conclusion: We believe this to be the first published case of hypersensitivity associated with rivaroxaban. More research is needed to determine this association. At the same time, given the growing range and increasing use of anticoagulants, particular vigilance is required regarding potential side effects so that these may be managed quickly and effectively in the early stages.

2012 Blackwell Publishing Ltd.
Publication Type: Journal: Article
Source: EMBASE

New risk prediction tool for venous thromboembolism

Venous thromboembolism (VTE) is a condition in which a blood clot (a thrombus) forms in a vein. Embolism occurs when the thrombus dislodges from its site of origin and travels in the blood.

VTE is an important and preventable cause of morbitity and mortality, with almost a third of survivors experiencing long term effects. To improve survival and prevent complications, the occurence of VTE needs to be reduced.

Current advice: NICE guidance on reducing the risk of VTE in patients admitted to hospital, highlights the need for new research to develop and validate risk prediction models for use by primary care research databases.

Although there are currently no validated algorithms to predict risk for VTE designed for use in primary care, computerised clinical decision support could improve appropriate use of thromboprophylaxis in a hospital setting.

Extended VTE prophylaxis is a research recommendation in the current NICE guidance and features in the VTE NICE Quality Standard.

NICE has guidance in development on the management of venous thromboembolic diseases and the role of thrombophilia testing.

See New Evidence

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