ReviewAnnals of the New York Academy of Sciences2016
The emerging threat of superwarfarins: history, detection, mechanisms, and countermeasures.
Review in Annals of the New York Academy of Sciences, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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
28 citing papers in PubMed, 68 citations in OpenAlex.
- The long-acting anticoagulant rodenticide brodifacoum induces neuropathology in adult New Zealand White rabbits and is reduced by the bile sequestrant cholestyramine.Neurotoxicology · 2026Article
- Exposure of Domestic Cats (Toxics · 2025Article
- Effects of Long-Acting Anticoagulant Rodenticides on Rabbit Plasma Extracellular Vesicles.ACS omega · 2025Article
- Alterations in the cecal microbiome of New Zealand White rabbits due to the long-acting anticoagulant rodenticide brodifacoum.Toxicology communications · 2025Article
- Deploying Validated Mass Spectrometry for Frontline Detection and Treatment of Human Poisoning by Long-Acting Anticoagulant Rodenticides.Chemical research in toxicology · 2024Article
- Short-term treatment with cholestyramine increases long-acting anticoagulant rodenticide clearance from rabbits without affecting plasma vitamin K1 levels or blood coagulation.Toxicological sciences : an official journal of the Society of Toxicology · 2024Article
- Article
- Methods in food defence: a simple and robust screening for 16 rodenticides by LC-DAD/FLD following QuEChERS-based extraction.Analytical and bioanalytical chemistry · 2022Article
- Superwarfarin poisoning: challenges still remain.BMJ case reports · 2022Article
- Methanol Intoxication After Suicidal Ingestion of Liquid Rodenticides: A Report of Two Cases.Journal of acute medicine · 2022Article
- Comparative pharmacokinetics of difethialone stereoisomers in male and female rats and mice: development of an intra- and inter-species model to predict the suitable formulation mix.Archives of toxicology · 2022Article
- Chiral liquid chromatography-tandem mass spectrometry analysis of superwarfarin rodenticide stereoisomers - Bromadiolone, difenacoum and brodifacoum - In human plasma.Journal of chromatography. B, Analytical technologies in the biomedical and life sciences · 2021Article
- Acute toxic encephalopathy following bromadiolone intoxication: a case report.BMC neurology · 2021Article
- Effects of vitamin K1 treatment on plasma concentrations of long-acting anticoagulant rodenticide enantiomers following inhalation of contaminated synthetic cannabinoids.Clinical toxicology (Philadelphia, Pa.) · 2020Article
- Separation and Quantification of Superwarfarin Rodenticide Diastereomers-Bromadiolone, Difenacoum, Flocoumafen, Brodifacoum, and Difethialone-in Human Plasma.Journal of AOAC International · 2020Article
- Biomarkers Potency to Monitor Non-target Fauna Poisoning by Anticoagulant Rodenticides.Frontiers in veterinary science · 2020Review
- Superwarfarin (Long-Acting Anticoagulant Rodenticides) Poisoning: from Pathophysiology to Laboratory-Guided Clinical Management.The Clinical biochemist. Reviews · 2019Review
- Observational
- Article
- Disseminated Intravascular Coagulopathy Secondary to Unintentional Brodifacoum Poisoning via Synthetic Marijuana.Journal of hematology · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 5 institutions in 1 country.
Funding
Abstract
Superwarfarins were developed following the emergence of warfarin resistance in rodents. Compared to warfarin, superwarfarins have much longer half-lives and stronger affinity to vitamin K epoxide reductase and therefore can cause death in warfarin-resistant rodents. By the mid-1970s, the superwarfarins brodifacoum and difenacoum were the most widely used rodenticides throughout the world. Unfortunately, increased use was accompanied by a rise in accidental poisonings, reaching >16,000 per year in the United States. Risk of exposure has become a concern since large quantities, up to hundreds of kilograms of rodent bait, are applied by aerial dispersion over regions with rodent infestations. Reports of intentional use of superwarfarins in civilian and military scenarios raise the specter of larger incidents or mass casualties. Unlike warfarin overdose, for which 1-2 days of treatment with vitamin K is effective, treatment of superwarfarin poisoning with vitamin K is limited by extremely high cost and can require daily treatment for a year or longer. Furthermore, superwarfarins have actions that are independent of their anticoagulant effects, including both vitamin K-dependent and -independent effects, which are not mitigated by vitamin K therapy. In this review, we summarize superwarfarin development, biology and pathophysiology, their threat as weapons, and possible therapeutic approaches.
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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.