Prescribing Advice for GPs

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MeReC Extra 24

The National Prescribing Centre (NPC) has published MeReC Extra 24, it details the results of the ACTIVE W Study, future changes in controlled drug management and reminders about CFC free beclometasone and the important health benefits associated with smoking cessation.

Patients with atrial fibrillation are currently recommended to receive aspirin therapy if they are at low risk of stroke and therapy with warfarin at high risk of stroke. The ACTIVE W Study examined the efficacy of the combination of aspirin and clopidogrel versus warfarin in preventing stroke in moderate to high risk patients.

The primary outcome of stroke, systemic embolus, myocardial infarction or vascular death occurred less frequently in the warfarin group with a relative risk reduction of 44% (ARR 2.1%). The risk of stroke was also lower in the warfarin group with a relative risk reduction of 72% (ARR 1.25%). Additionally, the risk of bleeding was 21% lower in the warfarin group (ARR 2.8%).

The NPC conclude that this study "supports the use of warfarin in patients with AF who are at high risk of stroke".

The remaining sections provide reminders about the MHRA advice about prescribing of CFC free beclometasone inhalers, planned changes to the inspection and monitoring of controlled drugs and the role healthcare professionals can play in promoting smoking cessation.

Action: Clinicians involved in the treatment of AF will find the review of the ACTIVE W Study interesting. Other sections provide useful links to further information.

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