In view of a new patients’ survey reveals a significant proportion still not receiving adequate treatment for atrial fibrillation, the commonest heart rhythm disorder, a new blood-thinning drug therapy to help prevent stroke in patients with the heart rhythm condition called non-valvular atrial fibrillation (NVAF) was launched today.
Atrial Fibrillation Patient Research sruvey carried out online by Opinion Health in June 2015 shows a significant proportion of patients are still not receiving appropriate therapy to protect them against AF-related stroke. The survey also revealed that patients sometimes experience extreme emotional distress living with the condition.
The new drug launched today is called Lixiana (edoxaban) as one of the blood-thinning drugs called Novel Oral Anti-Coagulants (NOACs), used in NVAF as an option to warfarin to reduce the risk of blood clots. The cardiac irregularity caused by AF means clots are more likely to form in the heart, which can then travel to the brain. Patients with AF are five times more likely to suffer a stroke than those without the condition.
Edoxaban, made by the pharmaceutical company Daiichi Sankyo, will also be used to protect patients from a recurrence if they have suffered from blood clots in the limbs and lungs, known as venous thromboembolism. This term covers both deep vein thrombosis and the potentially fatal pulmonary embolism.
Professor Gregory Lip, from the University of Birmingham, who has carried out studies on edoxaban for NVAF, welcomed an addition to the therapy armoury.
“A few years ago, all we had to prevent strokes in AF patients was warfarin, which imposes many lifestyle restrictions on patients and needs monitoring with a blood test system known as INR. Now we are spoilt for choice with modern blood-thinning drugs that do not need INR monitoring and are easy for patients to live with.”
Dr Alexander Cohen, Consultant Vascular Physician from Guy’s and St Thomas’ Hospitals, Kings College London, who has researched edoxaban for venous thromboembolism (VTE), also welcomed an additional resource to tackle the condition.
“Venous thromboembolism has a high rate of recurrence, which can be fatal. We need more tools to protect patients from a second incident and edoxaban will be of great use to help tailor treatments to specific patients.”
The new survey into the lives of people with AF looked at 200 patients, 41.5% male and 58.5% female, from across the UK, ranging in age from 36 to 84. The mean age at time of diagnosis was 59.
Around two-thirds (68%) of patients experienced symptoms before their first consultation with a doctor, although 32% did not.
Despite having symptoms the average delay before seeking medical help was two years. However, one in seven patients with symptoms (14%) waited five years or longer before seeing a doctor.
The main reasons for delaying was that patients did not know their symptoms were related to AF or they did not think they were serious enough. Symptoms included irregular heartbeat, breathlessness and dizziness.
At diagnosis around half the patients did not understand what AF was, and a similar proportion failed to realise the link between a heart condition and a possible stroke.
After diagnosis, 70.5% of patients were put on some type of blood-thinning medication.Half of patients (50%) said they were not told different medications were available to reduce the risk from an AF-related stroke.
Asked about current medication, around one in seven patients (14.7%) were taking aspirin although the survey data does not allow a distinction between those solely taking aspirin and those on aspirin also taking other medications.
Guidelines from the National Institute for Health and Care Excellence (NICE) said in June 2014 that aspirin should not be used on its own in AF patients for stroke prevention, as it did not work but did increase bleeding risks.
More than half of patients (56.5%) were taking warfarin and around one in six (16.3%) one of the NOAC therapies.
Around six out of ten patients (57%) said AF had significantly worsened their lives, with the impact on emotional well-being being highlighted as the greatest adverse effect.
Commenting on the findings Trudie Lobban MBE, Founder and CEO of the Atrial Fibrillation Association, said: “It is very worrying that patients with symptoms wait two years on average before seeking medical help. All that time they are exposed to a much higher risk of stroke due to suffering with AF, a major cause of stroke. The public needs to understand that symptoms such as breathlessness, dizziness and heart palpitations need to be checked at once by a doctor.”