Navigating the NVAF Patient Journey
Hear from expert Dr Manesh Patel as we follow a patient with Non-Valvular Atrial Fibrillation, considering their renal function at every step.
1. Joe’s CHA2DS2-VASc score: 3
NICE 2021:1[1]
OFFER anticoagulation with a DOAC to people with NVAF and a CHA2DS2‑VASc score of 2 or above, taking into account the risk of bleeding.
- Managing stroke prevention in patients with NVAF and diabetesexpand_more
View Prescribing Information and Adverse Event Reporting.
Presented by: Dr Manesh Patel
2. What dose of Xarelto should Joe receive?
Xarelto dosing algorithm[2]
*Rivaroxaban should be used with caution in patients with CrCl 15-29 mL/min and in patients with renal impairment concomitantly receiving other medicinal products which increase rivaroxaban plasma concentrations. Use is not recommended in patients with CrCl < 15mL/min.[2]
Joe’s CrCl is 52 mL/min so he should receive 20 mg Xarelto OD
- Selecting the appropriate DOAC dose and supporting medication adherenceexpand_more
View Prescribing Information and Adverse Event Reporting.
Presented by: Dr Manesh Patel
3. 8 years later, Joe’s renal function has declined
Joe’s dose of Xarelto is reduced to 15 mg OD
- Considerations around renal function when prescribing DOACsexpand_more
View Prescribing Information and Adverse Event Reporting.
Presented by: Dr Manesh Patel
4. Does Joe’s renal impairment impact choice of DOAC?
- The impact of renal impairment on choice of DOACexpand_more
View Prescribing Information and Adverse Event Reporting.
Presented by: Dr Manesh Patel
RP-XAR-GB-5143 | February 2024
- Referencesexpand_more
- 1NICE Clinical Guideline (NG196). Available at: https://www.nice.org.uk/guidance/ng196 (Last Accessed February 2024)
- 2Xarelto (rivaroxaban) Summary of Product Characteristics, UK.
- 3Yao X et al. J Am Coll Cardiol 2017;70:2321–2632;
- 4Pérez AG et al. Int J Cardiol. 2022;352:165–171;
- 5Kreutz R et al. ACC. Washington DC, USA, 2–4 April 2022.