PMID- 21073580
OWN - NLM
STAT- MEDLINE
DCOM- 20110620
LR  - 20141113
IS  - 1365-3148 (Electronic)
IS  - 0958-7578 (Linking)
VI  - 21
IP  - 2
DP  - 2011 Apr
TI  - Fixed versus variable dose of prothrombin complex concentrate for counteracting 
      vitamin K antagonist therapy.
PG  - 116-23
LID - 10.1111/j.1365-3148.2010.01050.x [doi]
AB  - BACKGROUND: Although prothrombin complex concentrate (PCC) is often used to 
      counteract vitamin K antagonist (VKA) therapy, evidence regarding the optimal 
      dose for this indication is lacking. In Dutch hospitals, either a variable dose, 
      based on body weight, target INR (international normalised ratio) and initial 
      INR, or a fixed dose is used. AIM/OBJECTIVES: In this observational, pilot study, 
      the efficacy and feasibility of the fixed dose strategy compared to the variable 
      dosing regimen, is investigated. MATERIALS AND METHODS: Consecutive patients 
      receiving PCC (Cofact(R), Sanquin, Amsterdam) for VKA reversal because of a major 
      non-cranial bleed or an invasive procedure were enrolled in two cohorts. Data 
      were collected prospectively in the fixed dose group, cohort 1, and 
      retrospectively in the variable dose regimen, cohort 2. Study endpoints were 
      proportion of patients reaching target INR and successful clinical outcome. 
      RESULTS: Cohort 1 consisted of 35 and cohort 2 of 32 patients. Target INR was 
      reached in 70% of patients in cohort 1 versus 81% in cohort 2 (P = 0.37). 
      Successful clinical outcome was seen in 91% of patients in cohort 1 versus 94% in 
      cohort 2 (P = 1.00). Median INR decreased from 4.7 to 1.8 with a median dosage of 
      1040 IU factor IX (F IX) in cohort 1 and from 4.7 to 1.6 with a median dosage of 
      1580 IU F IX in cohort 2. CONCLUSION: This study suggests that a fixed dose of 
      1040 IU of F IX may be an effective way to rapidly counteract VKA therapy in our 
      patient population and provides a basis for future research.
CI  - (c) 2010 The Authors. Transfusion Medicine (c) 2010 British Blood Transfusion 
      Society.
FAU - Khorsand, N
AU  - Khorsand N
AD  - Department of Hospital Pharmacy, Medical Centre Haaglanden, The Hague, The 
      Netherlands. N.Khorsand@hagaziekenhuis.nl
FAU - Veeger, N J G M
AU  - Veeger NJ
FAU - Muller, M
AU  - Muller M
FAU - Overdiek, J W P M
AU  - Overdiek JW
FAU - Huisman, W
AU  - Huisman W
FAU - van Hest, R M
AU  - van Hest RM
FAU - Meijer, K
AU  - Meijer K
LA  - eng
PT  - Journal Article
DEP - 20101115
PL  - England
TA  - Transfus Med
JT  - Transfusion medicine (Oxford, England)
JID - 9301182
RN  - 0 (Anticoagulants)
RN  - 0 (Antidotes)
RN  - 0 (Blood Coagulation Factors)
RN  - 12001-79-5 (Vitamin K)
RN  - 37224-63-8 (prothrombin complex concentrates)
RN  - 5Q7ZVV76EI (Warfarin)
RN  - I6WP63U32H (Acenocoumarol)
RN  - Q08SIO485D (Phenprocoumon)
SB  - IM
MH  - Acenocoumarol/adverse effects/antagonists & inhibitors
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/adverse effects/*antagonists & inhibitors
MH  - Antidotes/*administration & dosage/therapeutic use
MH  - Blood Coagulation Factors/*administration & dosage/therapeutic use
MH  - Cohort Studies
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Hemorrhage/chemically induced/prevention & control
MH  - Humans
MH  - International Normalized Ratio
MH  - Male
MH  - Middle Aged
MH  - Phenprocoumon/adverse effects/antagonists & inhibitors
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Vitamin K/*antagonists & inhibitors
MH  - Warfarin/adverse effects/antagonists & inhibitors
EDAT- 2010/11/16 06:00
MHDA- 2011/06/21 06:00
CRDT- 2010/11/16 06:00
PHST- 2010/11/16 06:00 [entrez]
PHST- 2010/11/16 06:00 [pubmed]
PHST- 2011/06/21 06:00 [medline]
AID - 10.1111/j.1365-3148.2010.01050.x [doi]
PST - ppublish
SO  - Transfus Med. 2011 Apr;21(2):116-23. doi: 10.1111/j.1365-3148.2010.01050.x. Epub 
      2010 Nov 15.