UK’s NICE allows limited use of prasugrel

The UK’s National Institute for Health and Clinical Excellence (NICE) has recommended prasugrel (Efient) for use in the National Health Service, but only under limited conditions. Specifically, the guidance document specified that prasugrel should only be used during PCI for ACS only when emergent PCI is required for a STEMI, for stent thrombosis in patients treated with clopidogrel, or when a patient has diabetes.

Patients already receiving prasugrel prior to the guidance may continue to receive the drug. An article in PharmaTimes quoted Dr Carole Longson, Director at NICE, who said prasugrel will “offer an additional treatment option for these specific individuals at risk of blood clots.”

Click here to read a PharmaTimes story by Selina McKee.

Click here for the NICE page with links to the guidance documents.

Click here for a Chronology of the Prasugrel Controversy.

Here is the NICE summary:

Prasugrel for the treatment of acute coronary syndromes with percutaneous coronary intervention

Prasugrel in combination with aspirin is recommended as an option for preventing blockages in the arteries of people with acute coronary syndromes who are having a treatment called percutaneous coronary intervention only when:

  • immediate percutaneous coronary intervention is necessary to treat an ST-segment-elevation myocardial infarction (a type of heart attack) or
  • a blood clot has blocked a stent (a small mesh-like tube inserted into an artery to keep it open) during treatment with a drug called clopidogrel or
  • the patient has diabetes mellitus.

Healthcare professionals should not stop prescribing prasugrel for people who were already taking it when the guidance was issued. These people should be able to carry on taking prasugrel until they and their healthcare professionals decide that it is the right time to stop treatment.

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