Trial reportThrombosis and haemostasis2012
Prospective pilot trial of PerMIT versus standard anticoagulation service management of patients initiating oral anticoagulation.
Trial report in Thrombosis and haemostasis, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 7 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Telemedicine-Based Management of Oral Anticoagulation Therapy: Systematic Review and Meta-analysis.Journal of medical Internet research · 2023Pooled it
- Genotype-guided warfarin dosing vs. conventional dosing strategies: a systematic review and meta-analysis of randomized controlled trials.British journal of clinical pharmacology · 2018Pooled it
- Are Evidence Standards Different for Genomic- vs. Clinical-Based Precision Medicine? A Quantitative Analysis of Individualized Warfarin Therapy.Clinical pharmacology and therapeutics · 2017Pooled it
- Limited clinical utility of genotype-guided warfarin initiation dosing algorithms versus standard therapy: a meta-analysis and trial sequential analysis of 11 randomized controlled trials.The pharmacogenomics journal · 2015Pooled it
- Genotype-guided drug prescribing: a systematic review and meta-analysis of randomized control trials.British journal of clinical pharmacology · 2015Pooled it
- Meta-analysis of Randomized Controlled Trials of Genotype-Guided vs Standard Dosing of Warfarin.Chest · 2015Pooled it
- Pharmacogenetics-Based versus Conventional Dosing of Warfarin: A Meta-Analysis of Randomized Controlled Trials.PloS one · 2015Pooled it
- CYP2C9 and VKORC1 genotyping for the quality of long-standing warfarin treatment in Russian patients.The pharmacogenomics journal · 2020Trial
- Implementation of pharmacogenomic clinical decision support for health systems: a cost-utility analysis.The pharmacogenomics journal · 2022Article
- Ethnic Diversity and Warfarin Pharmacogenomics.Frontiers in pharmacology · 2022Review
- Pharmacogenetics of warfarin dosing in patients of African and European ancestry.Pharmacogenomics · 2018Review
- Quality of anticoagulation control and hemorrhage risk among African American and European American warfarin users.Pharmacogenetics and genomics · 2017Article
- Guidance for the practical management of warfarin therapy in the treatment of venous thromboembolism.Journal of thrombosis and thrombolysis · 2016Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
We performed a randomised pilot trial of PerMIT, a novel decision support tool for genotype-based warfarin initiation and maintenance dosing, to assess its efficacy for improving warfarin management. We prospectively studied 26 subjects to compare PerMIT-guided management with routine anticoagulation service management. CYP2C9 and VKORC1 genotype results for 13 subjects randomly assigned to the PerMIT arm were recorded within 24 hours of enrolment. To aid in INR interpretation, PerMIT calculates estimated loading and maintenance doses based on a patient's genetic and clinical characteristics and displays calculated S-warfarin plasma concentrations based on planned or administered dosages. In comparison to control subjects, patients in the PerMIT study arm demonstrated a 3.6-day decrease in the time to reach a stabilised INR within the target therapeutic range (4.7 vs. 8.3 days, p = 0.015); a 12.8% increase in time spent within the therapeutic interval over the first 25 days of therapy (64.3% vs. 55.3%, p = 0.180); and a 32.9% decrease in the frequency of warfarin dose adjustments per INR measurement (38.3% vs. 57.1%, p = 0.007). Serial measurements of plasma S-warfarin concentrations were also obtained to prospectively evaluate the accuracy of the pharmacokinetic model during induction therapy. The PerMIT S-warfarin plasma concentration model estimated 62.8% of concentrations within 0.15 mg/l. These pilot data suggest that the PerMIT method and its incorporation of genotype/phenotype information may help practitioners increase the safety, efficacy, and efficiency of warfarin therapeutic management.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.