Warfarin dosing strategies evolution and its progress in the era of precision medicine, a narrative review
<p>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...
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2022
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| _version_ | 1864513567534874624 |
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| author | Amr Mohamed Fahmi (14151513) |
| author2 | Hazem Elewa (3592601) Islam El Jilany (14151516) |
| author2_role | author author |
| author_facet | Amr Mohamed Fahmi (14151513) Hazem Elewa (3592601) Islam El Jilany (14151516) |
| author_role | author |
| dc.creator.none.fl_str_mv | Amr Mohamed Fahmi (14151513) Hazem Elewa (3592601) Islam El Jilany (14151516) |
| dc.date.none.fl_str_mv | 2022-11-22T21:14:10Z |
| dc.identifier.none.fl_str_mv | 10.1007/s11096-022-01386-8 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Warfarin_dosing_strategies_evolution_and_its_progress_in_the_era_of_precision_medicine_a_narrative_review/21597465 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Pharmacology and pharmaceutical sciences Pharmacology (medical) Pharmaceutical Science Pharmacology Toxicology Pharmacy |
| dc.title.none.fl_str_mv | Warfarin dosing strategies evolution and its progress in the era of precision medicine, a narrative review |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <p>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.</p><h2>Other Information</h2> <p> Published in: International Journal of Clinical Pharmacy<br> License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1007/s11096-022-01386-8" target="_blank">http://dx.doi.org/10.1007/s11096-022-01386-8</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_012e524ca2d4b4f92b56a74f4e44b339 |
| identifier_str_mv | 10.1007/s11096-022-01386-8 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/21597465 |
| publishDate | 2022 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Warfarin dosing strategies evolution and its progress in the era of precision medicine, a narrative reviewAmr Mohamed Fahmi (14151513)Hazem Elewa (3592601)Islam El Jilany (14151516)Pharmacology and pharmaceutical sciencesPharmacology (medical)Pharmaceutical SciencePharmacologyToxicologyPharmacy<p>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.</p><h2>Other Information</h2> <p> Published in: International Journal of Clinical Pharmacy<br> License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1007/s11096-022-01386-8" target="_blank">http://dx.doi.org/10.1007/s11096-022-01386-8</a></p>2022-11-22T21:14:10ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1007/s11096-022-01386-8https://figshare.com/articles/journal_contribution/Warfarin_dosing_strategies_evolution_and_its_progress_in_the_era_of_precision_medicine_a_narrative_review/21597465CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/215974652022-11-22T21:14:10Z |
| spellingShingle | Warfarin dosing strategies evolution and its progress in the era of precision medicine, a narrative review Amr Mohamed Fahmi (14151513) Pharmacology and pharmaceutical sciences Pharmacology (medical) Pharmaceutical Science Pharmacology Toxicology Pharmacy |
| status_str | publishedVersion |
| title | Warfarin dosing strategies evolution and its progress in the era of precision medicine, a narrative review |
| title_full | Warfarin dosing strategies evolution and its progress in the era of precision medicine, a narrative review |
| title_fullStr | Warfarin dosing strategies evolution and its progress in the era of precision medicine, a narrative review |
| title_full_unstemmed | Warfarin dosing strategies evolution and its progress in the era of precision medicine, a narrative review |
| title_short | Warfarin dosing strategies evolution and its progress in the era of precision medicine, a narrative review |
| title_sort | Warfarin dosing strategies evolution and its progress in the era of precision medicine, a narrative review |
| topic | Pharmacology and pharmaceutical sciences Pharmacology (medical) Pharmaceutical Science Pharmacology Toxicology Pharmacy |