“Generally, by the time you are Real, most of your hair has been loved off, and your eyes drop out and you get loose in the joints and very shabby. But these things don't matter at all, because once you are Real you can't be ugly, except to people who don't understand.”
A DAILY £2 superpill is set to revolutionise the lives of millions of people at risk of a stroke.
Rivaroxaban is the first one-a-day clot-busting drug to be given the go-ahead for use on the NHS in 60 years. And it has fewer side-effects than the current treatment, meaning patients will be more inclined to take it.
Unlike other stroke drugs which are taken twice daily, rivaroxaban, which is also called Xarelto, can be taken just once a day.
It is just as effective at preventing strokes among people with atrial fibrillation as the current drug warfarin, originally developed six decades ago as a rat poison.
Atrial fibrillation, which can be caused by high blood pressure, heart valve disease, an overactive thyroid and alcohol, leads to 12,500 stroke deaths a year.
Sufferers have a faster than normal heartbeat, which may cause tiny blood clots. These can break up and travel towards the brain, triggering a stroke. Now the drug watchdog, Nice, is recommending rivaroxaban to stop the clots from forming.
Trudie Lobban, founder of the Atrial Fibrillation Association, said: “For almost 60 years there has only been one anti- coagulant, which sadly is not suitable for all sufferers.
“This latest approval by Nice will provide greater choice for the almost one million AF patients in England alone.”
It is difficult to regulate an effective dose of warfarin, which means patients must be monitored to ensure they do not take too much or too little. As well as being notoriously difficult to control, warfarin interacts with many other drugs as well as food and drink. Nice estimates that 46 per cent of patients who should be taking war-farin are not having it.
Rivaroxaban is given once daily at a fixed dose and does not need blood test monitoring. It can be used in patients with non-valvular AF who have one or more risk factors such as congestive heart failure, high blood pressure or a prior stroke.
Professor Carole Longson from Nice said: “We know some people taking warfarin find it difficult to maintain their blood clotting at a proper level.
“We are therefore pleased to recommend rivaroxaban as another cost-effective option for the prevention of stroke in people with atrial fibrillation.”
Dr Peter Coleman, deputy director of research at the Stroke Association, said: “Warfarin is a highly effective treatment for stroke prevention but is not suitable for everyone.
“It’s important to note that every AF patient needs to be treated on a case-by-case basis to ensure they receive the best possible treatment for them.”
Dee Maddock, senior cardiac nurse at the British Heart Foundation, said: “This will be welcome news to many as rivaroxaban doesn’t require close monitoring like warfarin does.”