Key revisions needed for draft NICE guidance for managing AF

In an opinion piece for the BMJ, Dr Raj Mattu (Kettering General Hospital, Kettering & University College London, London, UK) and colleagues — including Mrs Trudie Lobban MBE (Founder and CEO of Arrhythmia Alliance and AF Association) — state that the draft National Institute for Health and Care Excellence (NICE) guidance for managing atrial fibrillation (AF) “severely limit patient choice and access to appropriate treatments”.

They report: “Our greatest concerns about these draft guidelines surround NICE now advocating just two approved direct oral anticoagulants (DOACs)instead of four. This impacts all patients with ≥1 stroke risk factor, removing access to once daily medication, withdrawing patient choice, limiting patients’ options for tailored OAC therapy, and effectively rendering two DOACs (edoxaban and rivaroxaban) ineligible for AF. NICE’s draft recommends switching once-daily DOACs or warfarin to twice-daily therapies, even for patients who are stable with their treatment. This introduces unnecessary risks without proven advantages.”

Click here to read The NICE draft guidelines for the management of atrial fibrillation need key revisions editorial in full.

The 2021 NICE guidance for the management of AF is expected to be published on 12^th March 2021. Click here for more details.