Document Detail


Fixed versus variable dose of prothrombin complex concentrate for counteracting vitamin K antagonist therapy.
MedLine Citation:
PMID:  21073580     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although prothrombin complex concentrate (PCC) is often used to counteract vitamin K antagonist (VKA) therapy, evidence regarding the optimal dose for this indication is lacking. In Dutch hospitals, either a variable dose, based on body weight, target INR (international normalised ratio) and initial INR, or a fixed dose is used.
AIM/OBJECTIVES: In this observational, pilot study, the efficacy and feasibility of the fixed dose strategy compared to the variable dosing regimen, is investigated.
MATERIALS AND METHODS: Consecutive patients receiving PCC (Cofact®, Sanquin, Amsterdam) for VKA reversal because of a major non-cranial bleed or an invasive procedure were enrolled in two cohorts. Data were collected prospectively in the fixed dose group, cohort 1, and retrospectively in the variable dose regimen, cohort 2. Study endpoints were proportion of patients reaching target INR and successful clinical outcome.
RESULTS: Cohort 1 consisted of 35 and cohort 2 of 32 patients. Target INR was reached in 70% of patients in cohort 1 versus 81% in cohort 2 (P = 0·37). Successful clinical outcome was seen in 91% of patients in cohort 1 versus 94% in cohort 2 (P = 1·00). Median INR decreased from 4·7 to 1·8 with a median dosage of 1040 IU factor IX (F IX) in cohort 1 and from 4·7 to 1·6 with a median dosage of 1580 IU F IX in cohort 2.
CONCLUSION: This study suggests that a fixed dose of 1040 IU of F IX may be an effective way to rapidly counteract VKA therapy in our patient population and provides a basis for future research.
Authors:
N Khorsand; N J G M Veeger; M Muller; J W P M Overdiek; W Huisman; R M van Hest; K Meijer
Publication Detail:
Type:  Journal Article     Date:  2010-11-15
Journal Detail:
Title:  Transfusion medicine (Oxford, England)     Volume:  21     ISSN:  1365-3148     ISO Abbreviation:  Transfus Med     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-02-17     Completed Date:  2011-06-20     Revised Date:  2014-11-13    
Medline Journal Info:
Nlm Unique ID:  9301182     Medline TA:  Transfus Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  116-23     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors. Transfusion Medicine © 2010 British Blood Transfusion Society.
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MeSH Terms
Descriptor/Qualifier:
Acenocoumarol / adverse effects,  antagonists & inhibitors
Adult
Aged
Aged, 80 and over
Anticoagulants / adverse effects,  antagonists & inhibitors*
Antidotes / administration & dosage*,  therapeutic use
Blood Coagulation Factors / administration & dosage*,  therapeutic use
Cohort Studies
Dose-Response Relationship, Drug
Female
Hemorrhage / chemically induced,  prevention & control
Humans
International Normalized Ratio
Male
Middle Aged
Phenprocoumon / adverse effects,  antagonists & inhibitors
Prospective Studies
Retrospective Studies
Vitamin K / antagonists & inhibitors*
Warfarin / adverse effects,  antagonists & inhibitors
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Antidotes; 0/Blood Coagulation Factors; 12001-79-5/Vitamin K; 37224-63-8/prothrombin complex concentrates; 5Q7ZVV76EI/Warfarin; I6WP63U32H/Acenocoumarol; Q08SIO485D/Phenprocoumon

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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