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    Warfarin dosing strategies evolution and its progress in the era of precision medicine, a narrative review

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    s11096-022-01386-8 (1).pdf (597.9Kb)
    Date
    2022-06-01
    Author
    Fahmi, Amr Mohamed
    Elewa, Hazem
    El Jilany, Islam
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    Abstract
    Background For decades, vitamin K antagonists and specifically warfarin, have been the sole agents used orally to manage thromboembolic conditions, including stroke and venous thromboembolism (VTE). Several factors lead to warfarin dose variability, including genetic and non-genetic factors which made warfarin management challenging especially at the initiation phase. To overcome the challenges with warfarin dosing at initiation, strategies other than conventional or fixed dosing were introduced and explored. Aim In this narrative review, we aim to discuss and critique the different dosing strategies for warfarin at initiation with more focus on genotype-guided warfarin dosing and the most recent supporting evidence for and against its use. Method Medline database was searched from 1965 to July 2021. Articles addressing different warfarin dosing methods were screened for inclusion. Results A number of methods exist for warfarin initiation. Studies comparing different dosing methods for initiation yielded conflicting outcomes due to differences in study design, population studied, comparator, and outcomes measured. Conclusions Looking at the big picture, the use of genetic dosing for warfarin initiation can lead to better outcomes. Whether these better outcomes are clinically or economically beneficial remains controversial.
    URI
    https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85125640715&origin=inward
    DOI/handle
    http://dx.doi.org/10.1007/s11096-022-01386-8
    http://hdl.handle.net/10576/41371
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    • Pharmacy Research [‎1389‎ items ]

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    • CLINICAL VERSUS FIXED WARFARIN DOSING AND THE ADDED EFFECT OF A GENOTYPE GUIDED ALGORITHM ON WARFARIN DOSE PREDICTION IN ARABS 

      FAHMI, AMR MOHAMED MAHMOUD ABDELHAMID (2025 , Dissertation)
      Warfarin prescribing has been a challenge due to the need for frequent monitoring. Commonly, warfarin is prescribed using a fixed warfarin dosing method (FWD). Genotype guide warfarin dosing (GWD) is a method that uses ...
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      Evaluation of pharmacist-based compared to doctor-based anticoagulation management in Qatar 

      Elewa, Hazem; Jalali, Fatemeh; Khudair, Nada; Hassaballah, Noha; Abdelsamad, Osama; Mohammed, Shaban... more authors ... less authors ( Blackwell Publishing Ltd , 2016 , Article)
      Rationale, aims and objectives For over 60 years, warfarin has been the mainstay anticoagulant used in the outpatient setting for the prevention and treatment of a wide variety of thromboembolic clinical conditions. ...
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      The impact of genetic and non-genetic factors on warfarin dose prediction in MENA region: A systematic review 

      Bader, Loulia Akram; Elewa, Hazem ( Public Library of Science , 2016 , Article Review)
      Background Warfarin is the most commonly used oral anticoagulant for the treatment and prevention of thromboembolic disorders. Pharmacogenomics studies have shown that variants in CYP2C9 and VKORC1 genes are strongly and ...

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