Warfarin dosing strategies evolution and its progress in the era of precision medicine, a narrative review
الملخص
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.
معرّف المصادر الموحد
https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85125640715&origin=inwardالمجموعات
- أبحاث الصيدلة [1261 items ]
وثائق ذات صلة
عرض الوثائق المتصلة بواسطة: العنوان، المؤلف، المنشئ والموضوع.
-
Impact of GGCX, STX1B and FPGS Polymorphisms on Warfarin Dose Requirements in European-Americans and Egyptians
Hamadeh, IS; Shahin, MH; Lima, SM; Oliveira, F; Wilson, L; Khalifa, SI; Langaee, TY; Cooper-DeHoff, RM; Cavallari, LH; Johnson, JA... more authors ... less authors ( Blackwell Publishing Ltd , 2016 , Article)Genotype-based algorithms that include VKORC1 and CYP2C9 genotypes are less predictive of warfarin dose variability in Africans as opposed to Europeans. Polymorphisms in GGCX, FPGS, or STX1B are associated with warfarin ... -
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. ... -
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 ...