Evidence map›Paper›PMID 38859626›Full record

ArticleClinical and translational science2024

Clinical versus fixed warfarin dosing and the impact on quality of anticoagulation (The ClinFix trial).

Amr M Fahmi, Ahmed El Bardissy, Mohamed Omar Saad, Mohamed Nabil Elshafei, Loulia Bader, Ahmed Mahfouz, Mohamed Kasem, Osama Abdelsamad, Abdelnasser Elzouki, Christina L Aquilante and 7 more

Abstract readComparative Study
In one paragraph

Article in Clinical and translational science, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Derivation and Validation of a Genotype- Guided Warfarin Dosing Model in a Mixed Arab Population.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Amr M FahmiPharmacy Department, Hamad Medical Corporation, Doha, Qatar.ORCID 0000-0002-1502-6700
Ahmed El BardissyPharmacy Department, Hamad Medical Corporation, Doha, Qatar.ORCID 0000-0001-9009-0641
Mohamed Omar SaadPharmacy Department, Hamad Medical Corporation, Doha, Qatar.ORCID 0000-0002-2221-4216
Mohamed Nabil ElshafeiPharmacy Department, Hamad Medical Corporation, Doha, Qatar.ORCID 0000-0002-3229-6825
Loulia BaderCollege of Pharmacy, Qatar University, Doha, Qatar.ORCID 0000-0001-9276-6959
Ahmed MahfouzPharmacy Department, Hamad Medical Corporation, Doha, Qatar.ORCID 0000-0002-6253-1670
Mohamed KasemPharmacy Department, Hamad Medical Corporation, Doha, Qatar.ORCID 0009-0002-9879-3274
Osama AbdelsamadPharmacy Department, Hamad Medical Corporation, Doha, Qatar.ORCID 0000-0003-0262-2076
Abdelnasser ElzoukiDepartment of Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.ORCID 0000-0002-9132-1752
Christina L AquilanteDepartment of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, USA.ORCID 0000-0001-6609-6920
Fatima MraicheDepartment of Pharmacology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.ORCID 0000-0001-6188-1145
Ezeldin SoalyDepartment of Cardiology, AlWakra Hospital, Hamad Medical Corporation, AlWakra, Qatar.
Ihab El MadhounDepartment of Medicine, AlWakra Hospital, Hamad Medical Corporation, AlWakra, Qatar.ORCID 0000-0001-9115-0693
Nidal AsaadDepartment of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
Abdulrahman ArabiDepartment of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.ORCID 0000-0002-6581-2574
Eman AlhmoudPharmacy Department, Hamad Medical Corporation, Doha, Qatar.ORCID 0000-0002-3871-7088
Hazem ElewaCollege of Pharmacy, Qatar University, Doha, Qatar.ORCID 0000-0003-1594-1199

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Different dosing strategies exist to initiate warfarin, most commonly fixed warfarin dosing (FWD), clinical warfarin dosing (CWD), and genetic-guided warfarin dosing (GWD). Landmark trials have shown GWD to be superior when compared to FWD in the EU-PACT trial or CWD in the GIFT trial. COAG trial did not show differences between GWD and CWD. We aim to compare the anticoagulation quality outcomes of CWD and FWD. This is a prospective cohort study with a retrospective comparator. Recruited subjects in the CWD (prospective) arm were initiated on warfarin according to the clinical dosing component of the algorithm published in www.warfarindosing.org. The primary efficacy outcome was the percentage time in the therapeutic range (PTTR) from day 3 to 6 till day 28 to 35. The study enrolled 122 and 123 patients in the CWD and FWD, respectively. The PTTR did not differ statistically between CWD and FWD (62.2 ± 26.2% vs. 58 ± 25.4%, p = 0.2). There was also no difference between both arms in the percentage of visits with extreme subtherapeutic international normalized ratio (INR) (<1.5; 15 ± 18.3% vs. 16.8 ± 19.1%, p = 0.44) or extreme supratherapeutic INR (>4; 7.7 ± 14.7% vs. 7.5 ± 12.4%, p = 0.92). We conclude that CWD did not improve the anticoagulation quality parameters compared to the FWD method.

Indexed as

AnticoagulantsInternational Normalized RatioWarfarinAgedAged, 80 and overAlgorithmsBlood CoagulationDose-Response Relationship, DrugDrug MonitoringFemaleHumansMaleMiddle AgedProspective StudiesRetrospective StudiesTreatment OutcomeAnticoagulantsWarfarin

Identifiers

PMID38859626
PMCPMC11164972

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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.