A Randomized Trial of Genotype-Guided Dosing of Acenocoumarol and Phenprocoumon

Verhoef, Talitha I.; Ragia, Georgia; Boer, Anthonius de; Barallon, Rita; Kolovou, Genovefa; Kolovou, Vana; Konstantinides, Stavros; Cessie, Saskia le; Maltezos, Efstratios; Meer, F. J. M. Van Der; Redekop, William K.; Remkes, M. G. H.; Rosendaal, Frits R.; Schie, Rianne M. F. van; Tavridou, Anna; Tziakas, Dimitrios; Wadelius, Mia; Manolopoulos, Vangelis G.; Zee, Anke‐Hilse Maitland‐van der

doi:10.1056/nejmoa1311388

Cited by 208 publications

(212 citation statements)

References 18 publications

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“…Using non-profit website published algorithm http: //www.WarfarinDosing.org., we assessed initial pharmacogenetically-predicted warfarin dose, introducing a loading-dose strategy of warfarin for each patient in PhG during the first two to five days, while subsequently patients were treated on the basis of the INR (28)(29)(30). In the control group, warfarin was introduced by a fixed dose of 2 tablets of 3 mg warfarin (6 mg) for the first two to five days, and the doses …”

Section: Methodsmentioning

confidence: 99%

“…A study conducted by Pirmohamed group (EU-PACT trial) found that pharmacogenetic-based dosing was associated with a higher percentage of time in the therapeutic INR range than standard dosing during the initiation of warfarin therapy (27), while Kimmel group (COAG trial) did not confirm these findings for the anticoagulation period of the first 4 weeks of warfarin therapy (28). Also, Verhoef group did not confirm the findings for acenocoumarol or phenprocoumon during 12 weeks after the initiation of therapy in patients with atrial fibrillation or venous thromboembolism (29).…”

Section: Introductionmentioning

confidence: 97%

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Clinical Application of Genotype-guided Dosing of Warfarin in Patients with Acute Stroke

Šupe

Poljaković

Božina

et al. 2015

Archives of Medical Research

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Clinical Application of Genotype-guided Dosing of Warfarin in Patients with Acute Stroke

Šupe

Poljaković

Božina

et al. 2015

Archives of Medical Research

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“…Kreatinin klerensi <30 mL/dk altında olan kişilerde ciltaltı fondaparinuks kontraendikedir ve orta derecede böbrek yetersizliğinde (kreatinin klerensi 30-50 mL/dk) dozu %50 azaltılmalıdır 24 . 27 .…”

Section: Parenteral Antikoagülasyonunclassified

Pulmoner Embolinin Güncel Tedavisi

Tekin¹

2016

Arşiv Kaynak Tarama Dergisi

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Pulmonary embolism remains a major contributor to global disease burden. Risk-adapted treatment and follow-up contributes to a favorable outcome. The recommended definitive treatment for patients with high risk pulmonary embolism is thrombolysis. For patients with a contraindication to anticoagulation and thrombolytic therapy, surgical embolectomy and catheter-based therapies are options. In patients with intermediate-high risk pulmonary embolism, initiation of parenteral anticoagulation is recommended withour delay and thrombolytic therapy should only be given in case of hemodynamic worsening. Finally, direct oral anticoagulants have been shown to be as effective as and safer than the combination of low molecular weight heparin and vitamin K antagonist(s) in patients with low-to intermediate-risk pulmonary embolism. Key words: Pulmonary embolism, thrombolysis, anticoagulation. ÖZETPulmoner emboli küresel hastalık yüküne önemli bir katkıda bulunmaktadır. Risk uyumlu tedavi ve takip olumlu sonuçlar doğurmaktadır. Yüksek riskli pulmoner emboli hastasında tavsiye edilen kesin tedavi trombolizdir. Antikoagülasyon ve trombolitik tedaviye kontraendikasyonu olan hastalarda cerrahi embolektomi ve kateter aracılı tedaviler diğer şeçenektir. Orta-yüksek riskli pulmoner embolide parenteral antikoagülasyon gecikmeden başlanmalı ve hemodinamik kötüleşme olduğu takdirde trombolitik tedavi verilmelidir. Son olarak, düşük-orta riskli pulmoner embolide direkt oral antikoagülanların, düşük molekül ağırlıklı heparin ve K vitamini antagonisti kombinasyonu kadar etkin ve daha güvenli olduğu gösterilmiştir. Anahtar kelimeler: Pulmoner emboli, tromboliz, antikoagülasyon.

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“…L'étude conclut qu'inté-grer l'information génétique ne permet pas de mieux contrôler le dosage de warfarine au cours des quatre premières semaines de traitement. La seconde étude [22], portant sur 548 patients traités avec deux autres anticoagulants proches de la warfarine, l'acénocou-marol et le phenprocoumone, conclut également à l'absence d'amélioration du contrôle des doses au bout de 12 semaines de traitement, selon que la dose initiale est fixée par un algorithme intégrant des données que des différences de taux de concordance entre paires de jumeaux monozygotes et dizygotes, est considérée aujourd'hui comme bien décrite. Depuis l'identification d'un premier gène impliqué dans la susceptibilité à la maladie par l'équipe de Jean-Pierre Hugot en 2001 [12], la liste n'a cessé de s'allonger.…”

Section: L'exemple De La Maladie De Crohnunclassified

Génomique, de la recherche à la clinique

Bourgain

2014

Med Sci (Paris)

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> Alors que la génomique est parfois présentée comme un domaine de recherche dont les résul-tats passent rapidement dans les pratiques cliniques, la réalité est plus contrastée. Pour illustrer certaines des difficultés rencontrées, cet article s'intéresse aux applications des résultats obtenus par les études d'association sur tout le génome (GWAS, genome-wide association studies). Après avoir brièvement replacé les GWAS dans leur contexte scientifique, nous illustrons ces études par deux exemples emblématiques. Le cas de la maladie de Crohn permet de souligner les limites des résultats des GWAS en matière de prédiction individuelle de risque. Le cas de la warfarine met en lumière les difficultés à démontrer l'utilité clinique d'un recours aux données génétiques dans les décisions théra-peutiques. L'article insiste sur la simplification des modèles causatifs de maladie sous-tendant la méthodologie des GWAS. Fécond pour une démarche exploratoire de recherche, ce réduc-tionnisme, confronté à son utilisation clinique, montre ses limites.

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A Randomized Trial of Genotype-Guided Dosing of Acenocoumarol and Phenprocoumon

Cited by 208 publications

References 18 publications

Clinical Application of Genotype-guided Dosing of Warfarin in Patients with Acute Stroke

Clinical Application of Genotype-guided Dosing of Warfarin in Patients with Acute Stroke

Pulmoner Embolinin Güncel Tedavisi

Génomique, de la recherche à la clinique

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