title: Comparison of a single end point to determine optimal initial warfarin dosing (5 mg versus 10 mg) for venous thromboembolism.
abstract: There remains considerable controversy regarding optimal initial warfarin dosing in patients with acute venous thromboembolism. Therefore, an open-label, randomized trial comparing 2 warfarin initiation nomograms (5 vs 10 mg) was conducted in patients with acute venous thromboembolism. All participants received fondaparinux for > or = 5 days as a "bridge" to warfarin. The primary end point was defined as the number of days necessary to achieve 2 consecutive international normalized ratio laboratory test values > 1.9. A total of 50 patients were enrolled and randomly assigned to each of the treatment arms. The median time to 2 consecutive international normalized ratios was 5 days in the 2 groups. There was no statistical difference in achieving the primary end point using either the 5- or the 10-mg nomogram (p = 0.69). These results should provide clinicians with increased warfarin dosing options in patients presenting with acute venous thromboembolism.
authors.affiliation: Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Rene
authors.initials: R
authors.lastname: Quiroz
authors.forename: Marie
authors.initials: M
authors.lastname: Gerhard-Herman
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Kosowsky
authors.forename: Stacia M
authors.initials: SM
authors.lastname: DeSantis
authors.forename: Nils
authors.initials: N
authors.lastname: Kucher
authors.forename: Sylvia C
authors.initials: SC
authors.lastname: McKean
authors.forename: Samuel Z
authors.initials: SZ
authors.lastname: Goldhaber
mesh_terms: D000208:Acute Disease; D000925:Anticoagulants / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005170:Factor X; D005260:Female; D000077425:Fondaparinux; D006801:Humans; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides / Q000627:therapeutic use; D013923:Thromboembolism / Q000188:drug therapy*; D016896:Treatment Outcome; D014859:Warfarin / Q000008:administration & dosage*
chemical_list: D000925:Anticoagulants; D011134:Polysaccharides; D014859:Warfarin; D005170:Factor X; D000077425:Fondaparinux