Aims: Previous trials on the effectiveness of genotype-guided warfarin dosing vs. conventional dosing have been inconclusive. We conducted a systematic review and meta-analysis of randomized trials comparing genotype-guided to conventional dosing strategies.
Methods: PubMed and the Cochrane Library were searched up to 23 October 2017.
Results: A total of 76 and 94 entries were retrieved were retrieved from PubMed and the Cochrane Library, respectively. A total of 2626 subjects in the genotype-guided dosing (mean age 63.3 ± 5.8 years; 46% male) and 2604 subjects in the conventional dosing (mean age 64.7 ± 6.1 years; 46% male) groups (mean follow-up duration 64 days) from 18 trials were included. Compared with conventional dosing, genotype-guided dosing significantly shortened the time to first therapeutic international normalized ratio (INR) (mean difference 2.6 days, standard error 0.3 days; P < 0.0001; I 0%) and time to first stable INR (mean difference 5.9 days, standard error 2.0 days; P < 0.01; I 94%). Genotype-guided dosing also increased the time in therapeutic range (mean difference 3.1%, standard error 1.2%; P < 0.01; I 80%) and reduced the risks of both excessive anticoagulation, defined as INR ≥4 [risk ratio (RR) 0.87; 95% confidence interval (CI) 0.78, 0.98; P < 0.05; I : 0%), and bleeding (RR 0.82; 95% CI 0.69, 0.98; P < 0.05; I 31%). No difference in thromboembolism (RR 0.84; 95% CI 0.56, 1.26; P = 0.40; I 0%) or mortality (RR 1.16; 95% CI 0.46, 2.91; P = 0.76; I 0%) was observed between the two groups.
Conclusions: Genotype-guided warfarin dosing offers better safety with less bleeding compared with conventional dosing strategies. No significant benefit on thromboembolism or mortality was evident.
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http://dx.doi.org/10.1111/bcp.13621 | DOI Listing |
Disabil Rehabil
January 2025
Graduate Program in Psychology, Federal University of Sergipe, São Cristóvão, Brazil.
Purpose: This systematic review examined studies that addressed physiotherapy intervention approaches to the Quality of Life (QoL) of people with Cerebral Palsy (CP).
Materials And Methods: We conducted a comprehensive search strategy in five databases (PEDro, PubMed, Web of Science, Scopus, and Google Scholar) until 12 February 2024. We assessed the included studies' methodological quality and statistical description using the PEDro scale.
Nat Biotechnol
January 2025
Institute for Intelligent Biotechnologies (iBIO), Helmholtz Center Munich, Neuherberg, Germany.
Efficient and accurate nanocarrier development for targeted drug delivery is hindered by a lack of methods to analyze its cell-level biodistribution across whole organisms. Here we present Single Cell Precision Nanocarrier Identification (SCP-Nano), an integrated experimental and deep learning pipeline to comprehensively quantify the targeting of nanocarriers throughout the whole mouse body at single-cell resolution. SCP-Nano reveals the tissue distribution patterns of lipid nanoparticles (LNPs) after different injection routes at doses as low as 0.
View Article and Find Full Text PDFEgypt Heart J
January 2025
Department of Cardiology, Division of Heart & Lungs, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands.
Background: Hyponatremia is one of the complicating findings in acute decompensated heart failure. Decrease in cardiac output and systemic blood pressure triggers activation of renin-angiotensin-aldosterone system, antidiuretic hormone, and norepinephrine due to the perceived hypovolemia. Fluid-overloaded heart failure patients are commonly treated with loop diuretics, acutely decompensated heart failure patients tend to be less responsive to conventional oral doses of a loop diuretic, while other different diuretics could work in different part of nephron circulation system.
View Article and Find Full Text PDFACS Nano
January 2025
Department of Botany and Plant Sciences, University of California, Riverside, California 92521, United States.
Nitrogen fertilizer delivery inefficiencies limit crop productivity and contribute to environmental pollution. Herein, we developed Zn- and Fe-doped hydroxyapatite nanomaterials (ZnHAU, FeHAU) loaded with urea (∼26% N) through hydrogen bonding and metal-ligand interactions. The nanomaterials attach to the leaf epidermal cuticle and localize in the apoplast of leaf epidermal cells, triggering a slow N release at acidic conditions (pH 5.
View Article and Find Full Text PDFDrug Des Devel Ther
January 2025
School of Medicine, Kyungpook National University and Department of Clinical Pharmacology and Therapeutics, Kyungpook National University Hospital, Daegu, 41944, Republic of Korea.
Background: YYD601 is a new dual delayed-release formulation of esomeprazole, developed to enhance plasma exposure and prolong the duration of acid suppression.
Purpose: This study aimed to evaluate the safety, pharmacokinetic (PK), and pharmacodynamic (PD) profiles of YYD601 20 mg following single and multiple oral administrations in healthy, fasting adult Koreans, and to compare these outcomes to those of the conventional esomeprazole 20 mg capsule.
Methods: A randomized, open-label, two-period crossover study was conducted in 28 participants, who were divided into two treatment groups: one group received YYD601 20 mg, and the other received conventional esomeprazole 20 mg, once daily for five consecutive days.
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