Blood

The UK’s National Institute for Health and Care Excellence (NICE) has recommended the anti-blood clotting drug dabigatran, Boehringer Ingelheim’s Pradaxa, to treat fatal blood clots in the legs (deep vein thrombosis) and lungs (pulmonary embolism) in adults.

According to NICE, deep vein thrombosis (DVT) results when a blood clot (thrombus) forms in the deep veins of the leg or pelvis, and blood flow through the affected vein can be limited by the clot, which will cause swelling and pain in the leg.

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Fatal pulmonary embolism (PE) results if the blood clot dislodges and travels to the lungs, and even if blood clots are not fatal they can still result in long-term illness, including venous ulceration and chronic pain, swelling and skin changes in the affected limb.

"The appraisal committee felt that dabigatran represents a potential benefit for many people who have had a DVT or PE."

NICE health technology evaluation centre director professor Carole Longson said: "For many people, using warfarin can be difficult because of the need for frequent tests to see if the blood is clotting properly, and having to adjust the dose of the drug if it is not.

"The appraisal committee felt that dabigatran represents a potential benefit for many people who have had a DVT or PE, particularly those who have risk factors for recurrence of a blood clot and who therefore need longer term treatment."

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Dabigatran is priced at £65.90 for a 60 capsule pack of the 150mg or 110mg doses and costs £2.20 a day of treatment.

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NICE noted that risk factors for DVT and PE include a history of DVT, recent surgery, immobility, active cancer or cancer treatment, aged over 60 years, obesity, hormone replacement therapy or oestrogen containing contraceptive therapy and the presence of co-morbidities such as heart disease.

Image: The blood clot consists of erythrocytes (red areas) and plasma admixed with leukocytes (pale areas). Photo: courtesy of Yale Rosen.