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[Randomized Comparison of Two Approaches to Initial Warfarin Dosing: Time in Therapeutic Range of International

I G Gordeev¹, O V Averkov², L N Mishchenko¹

¹Federal State Budgetary Educational Institution of Higher Education, "Pirogov Russian National Research Medical University" of the Ministry of Health of the Russian Federation.

|February 22, 2018

Abstract

Aim:

To perform a randomized, open-label comparison of average time in therapeutic range (TTR) of international normalized ratio (INR) using two approaches to initial warfarin dosing during hospitalization: the standard method and the one using individual patient characteristics (clinical algorithm - the studied approach).

Materials And Methods:

We randomly assigned 60 patients with different indications for vitamin K antagonist therapy to the studied approach (n=31, intervention group) or to the standard method (n=29, control group). А target INR range for all patients was 2.0 to 3.0.

Results:

The average TTR and portions of INR values within target range during the whole time of drug dosing turned out to be small. TTR was 22.4% with standard method and 21.4% with clinical algorithm, which was well below desired 60%.

Conclusion:

The opportunities for achieving target INR in inpatient settings, regardless of warfarin dosing regimen, are limited.

Keywords:

SAMe-TT2R2 score international normalized ratio (INR)stable INR time in therapeutic range (TTR)warfarin warfarin dosing

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