Initiation of glucose-lowering treatment decreases international normalized ratio levels among users of vitamin K antagonists: a self-controlled register study

Initiation of glucose-lowering treatment decreases international normalized ratio levels among users of vitamin K antagonists : a self-controlled register study

Stage, Tore B. (author): Uppsala universitet,Institutionen för farmaceutisk biovetenskap,Univ Southern Denmark, Dept Publ Hlth, Clin Pharmacol, JB Winslows Vej 19, DK-5000 Odense, Denmark.

Pottegard, A. (author): Univ Southern Denmark, Dept Publ Hlth, Clin Pharmacol, JB Winslows Vej 19, DK-5000 Odense, Denmark.

Henriksen, D. P. (author): Odense Univ Hosp, Dept Clin Chem & Pharmacol, DK-5000 Odense, Denmark.

Christensen, M. M. H. (author): 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.

Hojlund, K. (author): Odense Univ Hosp, Dept Endocrinol, DK-5000 Odense, Denmark.

Brosen, K. (author): Univ Southern Denmark, Dept Publ Hlth, Clin Pharmacol, JB Winslows Vej 19, DK-5000 Odense, Denmark.

Damkier, P. (author): 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.

(creator_code:org_t)

Elsevier BV, 2016
2016
English.
In: Journal of Thrombosis and Haemostasis. - : Elsevier BV. - 1538-7933 .- 1538-7836. ; 14:1, s. 129-133

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Abstract Subject headings

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.

By the author/editor: Stage, Tore B.; Pottegard, A.; Henriksen, D. P.; Christensen, M. ...; Hojlund, K.; Brosen, K.; show more...; Damkier, P.; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Hematology

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

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