title: Anticoagulating obese patients in the modern era.
abstract: The prevalence of obesity has increased substantially over recent years. Clinicians are increasingly being challenged with making uncertain anticoagulant dosing decisions, as the optimal dosing strategy for most anticoagulants in the obese patient population remains unknown. Research published to date suggests that the clearance of anticoagulants increases with weight. As obesity is associated with an increased risk of venous thromboembolism and arterial disease, there is an urgent need to establish appropriate anticoagulation regimens for this patient group. Research studies applying the method of pharmacokinetic-pharmacodynamic modelling and simulation could establish an appropriate evidence base and provide direction and reassurance to prescribing clinicians.
authors.affiliation: King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital Foundation NHS Trust, London, UK. jig.patel@kcl.ac.uk
authors.forename: Jignesh P
authors.initials: JP
authors.lastname: Patel
authors.forename: Lara N
authors.initials: LN
authors.lastname: Roberts
authors.forename: Roopen
authors.initials: R
authors.lastname: Arya
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000188:drug therapy; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000008:administration & dosage / Q000627:therapeutic use; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D000069604:Dabigatran; D004311:Double-Blind Method; D065427:Factor Xa Inhibitors; D000077425:Fondaparinux; D006470:Hemorrhage / Q000139:chemically induced / Q000517:prevention & control; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D009025:Morpholines / Q000008:administration & dosage / Q000627:therapeutic use; D015337:Multicenter Studies as Topic; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000601:surgery; D011134:Polysaccharides / Q000008:administration & dosage / Q000627:therapeutic use; D011720:Pyrazoles / Q000008:administration & dosage / Q000627:therapeutic use; D011728:Pyridones / Q000008:administration & dosage / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D000069552:Rivaroxaban; D013876:Thiophenes / Q000008:administration & dosage / Q000627:therapeutic use; D013917:Thrombin / Q000037:antagonists & inhibitors; D019851:Thrombophilia / Q000150:complications / Q000188:drug therapy*; D020246:Venous Thrombosis / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control; D014859:Warfarin / Q000008:administration & dosage / Q000627:therapeutic use; D015091:beta-Alanine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D001562:Benzimidazoles; D065427:Factor Xa Inhibitors; D009025:Morpholines; D011134:Polysaccharides; D011720:Pyrazoles; D011728:Pyridones; D013876:Thiophenes; D015091:beta-Alanine; C522181:apixaban; D014859:Warfarin; D006493:Heparin; D000069552:Rivaroxaban; D013917:Thrombin; D000069604:Dabigatran; D000077425:Fondaparinux