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Initiation of gluco...
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Stage, Tore B.Uppsala universitet,Institutionen för farmaceutisk biovetenskap,Univ Southern Denmark, Dept Publ Hlth, Clin Pharmacol, JB Winslows Vej 19, DK-5000 Odense, Denmark.
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Initiation of glucose-lowering treatment decreases international normalized ratio levels among users of vitamin K antagonists : a self-controlled register study
- Article/chapterEnglish2016
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Elsevier BV,2016
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LIBRIS-ID:oai:DiVA.org:uu-282396
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-282396URI
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https://doi.org/10.1111/jth.13187DOI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Background: It is not known whether initiation of antidiabetic treatment affects the effect of vitamin K antagonists (VKAs). It was previously shown that metformin affects the effect of one VKA, phenprocoumon. Objectives: The aim of this study was to determine if initiation of glucose-lowering treatment affects the international normalized ratio (INR) and dose requirements of the anticoagulant VKAs warfarin and phenprocoumon. Patients/methods: We performed a self-controlled retrospective register-based study. A total of 118 patients commencing glucose-lowering treatment while being treated with warfarin or phenprocoumon were included in the study. We compared INR, dose/INR and proportion of patients with at least one sub-therapeutic INR measurement before and after initiation of glucose-lowering treatment. Results: Initiation of glucose-lowering treatment caused mean INR to decrease from 2.5 to 2.2 (decrease of -0.3 [95% CI: -0.1; -0.5]) and led to more than half of the patients having at least one sub-therapeutic INR measurement. Six to 12 weeks later, the VKA dose/INR was increased by 11%, indicating a weakened effect of the VKA. Conclusion: Initiation of glucose-lowering treatment reduces the anticoagulant effect of VKAs to an extent that is likely to be clinically relevant. This finding needs confirmation and mechanistic explanation.
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Pottegard, A.Univ Southern Denmark, Dept Publ Hlth, Clin Pharmacol, JB Winslows Vej 19, DK-5000 Odense, Denmark.
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Henriksen, D. P.Odense Univ Hosp, Dept Clin Chem & Pharmacol, DK-5000 Odense, Denmark.
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Christensen, M. M. H.Univ Southern Denmark, Dept Publ Hlth, Clin Pharmacol, JB Winslows Vej 19, DK-5000 Odense, Denmark.;Odense Univ Hosp, Dept Clin Chem & Pharmacol, DK-5000 Odense, Denmark.
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Hojlund, K.Odense Univ Hosp, Dept Endocrinol, DK-5000 Odense, Denmark.
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Brosen, K.Univ Southern Denmark, Dept Publ Hlth, Clin Pharmacol, JB Winslows Vej 19, DK-5000 Odense, Denmark.
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Damkier, P.Univ Southern Denmark, Dept Publ Hlth, Clin Pharmacol, JB Winslows Vej 19, DK-5000 Odense, Denmark.;Odense Univ Hosp, Dept Clin Chem & Pharmacol, DK-5000 Odense, Denmark.
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Uppsala universitetInstitutionen för farmaceutisk biovetenskap
(creator_code:org_t)
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In:Journal of Thrombosis and Haemostasis: Elsevier BV14:1, s. 129-1331538-79331538-7836
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